INTRODUCTION:

Cesarean delivery is one in everything about peak wide performed surgeries in maternity care around the world, it totally was in the fundamental advanced as a life saving method for mother and baby throughout the difficult delivery. There is a progressive raise in the abdominal delivery cases across the worldwide, in developing countries.¹

International cesarean section rate is on rise during the last decade there has been 2 to 3 fold increase in the incidence. World Health organization recommended that ten to fifteen percentage of must not exceeded. But the national lookout cesarean delivery audit shows the c-section delivery rates high above twenty four percentage in most of the developed and developing country²

Globally big difference is discovered in cesarean rates, highest rates being reportable in Latin America and thus the Caribbean region (40.5), followed by Northern America (32.3), Oceania (31.1), Europe (25), Asia (19.2) and Africa (7.3).³

Achieving reduces in maternal and infant morbidity and mortality are, amongst others, the targets promoted with the aid of using the World Health Organization for 2030. One of the cautioned methods to satisfy this aim includes averting clinically pointless caesareans. However, the venture is to maintain CS costs low even as making sure secure results for mothers and infants⁴

Caesarean section are effective in saving maternal and child lives, however only when they’re needed for medically indicated reasons. Every effort must be created to offer must be created to offer caesarean to women in want, rather than try to attain a specific rate, The outcomes of caesarean rates on different outcomes, like maternal and Perinatal morbidity, medicine outcomes, and psychological or social well-being are still unclear. lots of analysis is necessary to understand the effects of caesarean on immediate and future outcomes.⁵

METHODS:

This prospective study was conducted over a time of one year from 1^st April 2019 to March 2020, at selected Hospital, Mysore, Karnataka. Data of patient who delivered by cesarean in the hospital throughout the study was recorded and applied statistical analysis of varied parameters particularly, the rates, its indication of caesarean, and also compared with the total number of study and normal delivery during the study period

RESULT:

Demographical Variable Of Mother Who Have Undergone Cesarean Section-Age of the Mother

Table -1

Sl. no	Demographic data	numbers (n)	Percentage (%)
1	Age in years
a	18-22	379	20.77
b	23-27	856	46.9
c	28-32	482	26.41
d	>33	108	5.92
		1825	100

Figure-1

Majority of them belongs to the age group 23-27(46.9%) year, followed by 28-32(26.41%), 18-22(20.77%), and least is >33(5.92%), depicted in the table 1 and the figure -1

Demographical Variable Of Mother Who Have Undergone Cesarean Section Pairty of the Mother

Table -2

S. No	Demographic data	numbers (n)	Percentage (%)
2	Parity
a	parity one	986	54.03
b	parity two	749	41.04
c	parity three	80	4.38
d	parity four	10	0.55
		1825	100

Figure -2

Greater part women were underwent first time cesarean section i.e. parity one 986(45.03%), followed by the maximum of parity two749(41.04%), remaining were parity three 80(4.38) and lastly parity four 10(0.55%) as shown in table and figure-2

Type of Cesarean Section:

Table -3

	Type of Cesarean Section	numbers (n)	Percentage (%)
a	Emergency	1571	86.08
b	Elective cesarean section	254	13.92
		1825	100

Figure-3

The largest part of the women undergone emergency cesarean delivery 1571(86.08) and residual were gone for elective cesarean section254(13.92), depicted in table and figure 3 type of anesthesia

Table -4

	Type of anesthesia	numbers (n)	Percentage (%)
a	General	0	0
b	Spinal	1825	100

All have undergone c-section in spinal anesthesia 1825(100%) none of them taken general anesthesia

Number of deliveries:

Table -5

Total No of Delivery From April 2019 To March 2020	no. of normal delivery	no. of cesarean Section	Total of Delivery
	800	1825	2625
Total of Delivery			2625

Figure -5

There were total 2625 deliveries during the study period, out of that 800 were normal delivery and 1825 by cesarean section, shown in table and figure 5

Section B:

Indication Cesarean Delivery based on Fetal, maternal and combined

Table -7

	Indication of caesarean section	Numbers (n)	Percentage (%)
a	Fetal	500	27.4
b	Maternal	1070	58.63
c	Combined (Fetal and maternal)	255	13.97
		1825	100

Figure -7

The above table and figure-7 depict most of the mother undergone c-section for maternal indication 1070(58.63), followed by fetal indication 500(27.4) and residual are combined indication 255(13.97).

The dynamic indication and rate of cesarean delivery

Figure-8

The primary, secondary and tertiary indication of cesarean section in the present study is are previous cesarean section568(31.1%)Fetal distress 376(20.6) and Cephalo pelvic disproportion 245 (13.4%)remaining, failure to progress in labour 149(8.2%), Oligohydramnios 69(3.8).ect. as shown above

Cesarean Section Indication Based on Absolute and Relative Indication

Figure -9

Cephalo pelvic disproportion was the prime absolute indication 245(13.4%),followed by contracted pelvis18(1%), central placenta previa8 (0.4%) and left behind are fibroid in pregnancy and uterine rupture 1(0.1%) as reveal in table and figure 9

Relative Indication of Cesarean Section

Table-10

S. No	Relative Indication	Numbers (n)	Percentage (%)
1	previous cesarean section	568	31.1
2	Intrauterine growth retardation (IUGR)	16	0.9
3	Non-assuring FHR (Fetal distress)	376	20.6
4	Dystocia
	a) Deflexed Head	3	0.2
	b) Second stage arrest	8	0.4
	c) Fetal macrosomia	1	0.1
	d) Deep transverse arrest	9	0.5
	e) Obstructed labour	4	0.2
	f) Failure to progress	149	8.2
5	antepartum hemorrhage
	(a)-Placenta previa	11	0.6
	(b)-Abruptio placenta	3	0.2
6	Malpresentation -
	a) Breech	63	3.5
	b) Compound presentation	2	0.1
	c) Transverse lie	2	0.1
	d) Oblique lie	13	0.7
	e) Cord prolapse	1	0.1
7	Malposition
	a) Right Ocipito posterior (ROP)	2	0.1
	b) Deflexed Head	3	0.2
8	Bad obstetric history (BOH)	5	0.3
9	Hypertion Disorder-
	a) Pre-eclampsia	49	2.7
	b) Eclampsia	9	0.5
	c) Imminent Eclampsia	24	1.3
	d) Hypertension (HTN)	3	0.2
	e) HELLP Syndrome	5	0.3
	f) Gestational hypertension (GHT)	2	0.1
10	Medical Condition
	a) Anemia	1	0.1
	b) Heart disease
	Cardio myopathy	1	0.1
	c) Infection
	Hbsag positive	1	0.1
	Acute pancreatitis	1	0.1
11	Multiple pregnancy
	a) Twin gestation	17	0.9
	b) Triplet gestation	1	0.1
12	Abnormal amount of liquor amnii
	a) Polyhydramineose	5	0.3
	b) Oligohydramnios	69	3.8
13	Abnormal Duration of Labour
	a) Premature rupture of membrane (PROM)	41	2.2
	b) Pre-Term Premature rupture of membrane (PPROM)	32	1.8
	c) Post dated	1	0.1
14	Others
	a) Maternal request	16	0.9
	b) Maternal distress	1	0.1

Above table depict the relative indication like previous cesarean section, IUGR, Fetal distress, dystocia, ante partum hemorrhage, malpresentation and malposition, Bad Obstetric History, hypertension disorder, medical condition, multiple pregnancy, abnormal amount of liquor amnii, abnormal duration of labour and others.

Foremost relative indication is previous cesarean section 568(31.1%), followed by Fetal distress 376(20.6%) and remaining, failure to progress in labour 149(8.2%), Oligohydramnios 69 (3.8) ect.

Indication	Present Study	Meeta Gupta et al (%)	Saran Pet et al (%)	Jawa A	Chavda D et al (%)	Nikhil A et al (%)	G Singh et al (%)
Indication	Present Study	Meeta Gupta et al (%)	Saran Pet et al (%)	Jawa A	Chavda D et al (%)	Nikhil A et al (%)	G Singh et al (%)
Previous cesarean section	31.1	36.52	23	23.9	39.9o	42.09	29.7
Fetal distress	20.6	8.05	3.03	9.37	18.6	8.26	11.3
Cephalo pelvic disproportion	13.4	3.54	14	-	7.3	-	-
Failed induction	8.2	5.16	5	5.93	2	3.89	-
Oligohydroamnios/IUGR	4.7	12.03	2.02	5.93	4.8	6.32	5.1
Malpresentation	4.4	11.82	30.99	16.06	19.1	10.94	12.1
PIH	2.7	13	2.99	13	0.9	10.94	25.4
Arrest of labour	0.7	3.54	12.99	11.66	-	1.94	4.8

In the present study, Majority of them belongs to the age group 23-27(46.9%) year. Most of the women were underwent first time cesarean section i.e. parity one 986(45.03%) least of them are parity four 10(0.55%)

The largest part of the women undergone emergency cesarean delivery 1571(86.08%) were as elective cesarean section were 254(13.92%)

All have undergone c-section in spinal anesthesia 1825(100%) none of them taken general anesthesia

There were total 2625 deliveries during the study period, 800 were normal delivery and 1825 by cesarean section

The indication classified based on maternal, fetal and combined - majority mother undergone c-section for the maternal indication 1070(58.63%).

The primary, secondary and tertiary indication of cesarean section in the present study is are previous cesarean section 568(31.1%) Fetal distress 376(20.6) and Cephalo pelvic disproportion 245(13.4%) remaining, failure to progress in labour 149(8.2%), Oligohydramnios 69(3.8).

Rate of indication of cesarean section divided based on absolute and relative indication - the Cephalo pelvic disproportion was the prime absolute indication 245(13.4%) where as the Foremost relative indication is previous cesarean section 568(31.1%).

CONCLUSION:

Greatest stress connected to fetal welfare in today’s small family norm has modified the delivery practices in favour of cesarean delivery. To save lots of the life of the mother and baby cesarean section is opted. Caesarian section could be a major medical specialty intervention and regarded as a method indicator in maternal health to observe progress. In this study The primary, secondary and tertiary indication of cesarean section in the present study is are previous cesarean section 568(31.1%) Fetal distress 376(20.6) and Cephalo pelvic disproportion 245 (13.4%) remaining, failure to progress in labour 149(8.2%), Oligohydramnios 69(3.8) ect. There’s an incredible increase in population supported all totally different causes of caesarian section rate globally.

ACKNOWLEDGEMENT:

Author would like to acknowledge the our institution for allowing me to access the in –patient record file. Author would also like to thank Dr. Sujatha M S, who guided me to preparing manuscript.

CONFLICT OF INTEREST:

None declare.

ETHICAL CLEARANCE:

The study was approved by the Institutional Ethical committee.

REFERENCES:

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3. Singh, P., Hashmi, G. and Swain, P.K. High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India. BMC Public Health. 2018; 18: 613. https://doi.org/10.1186/s12889-018-5533-3.

4. Vila-Candel R, Martín A, Escuriet R, Castro-Sánchez E, Soriano-Vidal FJ. Analysis of Caesarean Section Rates Using the Robson Classification System at a University Hospital in Spain. International Journal of Environmental Research and Public Health 2020; 17: 1575.

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Received on 13.02.2025 Revised on 11.03.2025

Accepted on 01.04.2025 Published on 23.05.2025

Available online from May 26, 2025

A and V Pub Int. J. of Nursing and Med. Res. 2025; 4(2):82-86.

DOI: 10.52711/ijnmr.2025.17

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