Abstract
Objective: To determine sixteen-years' trend of cesarean section (CS), risk factors and attitudes towards it among females delivered at King Abdulaziz University Hospital (KAUH), Jeddah
Design: Two study designs were conducted during 2016. A retrospective study was done through reviewing of delivery records (2000-2015). The second design was a matched case-control study.
Setting: Obstetrics & Gynecology Department of KAUH
Subjects: For the retrospective study, females delivered during the 16 years were scrutinized. For the case-control study, 300 postpartum randomly selected females were recruited (150 cases delivered by CS, and an equal number of controls with vaginal delivery) matched by age and parity.
Intervention: Reviewing delivery records, an interviewing questionnaire with females, and clinical record abstraction forms. Descriptive and inferential statistics were done.
Main outcome measures: Trend, risk factors and attitudes towards CS
Results: An increasing CS trend was obvious (129.5% increase); from 13.86% (2000) to 31.81% (2015). CS delivery was significantly associated with high income, increased weight, smoking, gestational diabetes mellitus, and previous CS(s). Non-cephalic (breech and shoulder) presentation, multiple pregnancies, preterm delivery, fetal distress and low Bishop Score were important risk factors of CS. The most frequent CS indications were history of previous CS, fetal distress and maternal emergencies. CS was done according to mother's opinion for 3.7%. Regarding attitudes, females delivered by CS perceived it as a safer and more convenient delivery than controls.
Conclusion: Increasing rates of CS prevailed at KAUH. Females with high risk factors require adequate antenatal follow-up. Implementation of programs such as labor induction in low-risk pregnancies is recommended. Increased awareness about CS complicity and advantage of vaginal delivery is needed.