HIGH CESAREAN-SECTION RATE - A NEW PERSPECTIVE

  • 1 January 1985
    • journal article
    • research article
    • Vol. 65  (3) , 307-311
Abstract
Cesarean section rates in the USA have increased dramatically in recent years, whereas perinatal mortality rates have fallen. To investigate the hypothesis that these 2 events are not necessarily causally related, a prospective attempt to modify obstetric management directed at minimizing the rate of abdominal delivery while preserving excellent perinatal survival was done at a university-affiliated hospital in the Denver [Colorado, USA] metropolitan area. Unselected patients who were admitted to separate services at the hospital were used for comparison, with 1 group subject to the specific management criteria. Corrected mortality rates and low 5-min-Apgar scores on the 2 services were not significantly different after 2 yr. The total cesarean section rate on the 1st service was 5.7%, and the total cesarean section rate on the comparison service was 17.6%. Analysis of the data showed major differences in indications for cesarean section in the areas of repeat cesarean section, cephalopelvic disproportion, breech presentation, fetal distress, and genital herpes. Excellent perinatal outcome can be achieved with modest abdominal delivery rates.