Objectives: To study the caesarean section rate and the trends in indications for caesarean delivery at the Singapore General Hospital (SGH) during two study periods of 6 months each.Materials and Methods: The percentages of caesarean sections attributable to specific indications were computed for the first 6 months of 1998 and the last 6 months of 2001. Subgroup analysis of “less common indications” was performed. Results: In the first half of 1998, 170 caesarean sections were performed giving a rate of 16.77%. 54.12% of women were multiparous. The main indication for caesarean section was dystocia (4.24% of deliveries). Two hundred and sixty caesarean sections were performed in the later half of 2001 giving a caesarean section rate of 25.10%. 53.46% of women were multiparous. The main indication for caesarean section was dystocia (5.41% of deliveries). Increase in caesarean section rate in 2001 was attributed to statistically significant increase in caesarean section for previous caesarean section and placenta previa major. Other changes in practice included shorter operating time which may be related to decision not to perform peritoneal closure. Conclusion: Studying indications for caesarean section are useful for hospitals, clinicians and researchers in determining strategies to lower primary and repeat caesarean section rate.
Increasing rates of caesarean deliveries have received widespread attention in recent years and has increased widespread discussion in the public domain. The ideal caesarean section rate has never been defined and national rates of caesarean delivery vary from country to country.
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