Caesarean Section: A Necessary Evil?

Abhishek Malakar, Shiv Shankar Singh, Shreya Barik, Dhanisha S Awaradi 1Assistant Professor, 3Senior Resident, 4Internee, Department of Obstetrics and Gynaecology, ANIIMS, Port Blair, India. 2Associate Professor, Department of General Medicine, ANIIMS, Port Blair, India. DOI: https://doi.org/10.24321/2454.8642.201915 Background: Caesarean Section (CS) has become more prevalent over the years due to various factors and is exceeding the specified limit laid down by the WHO. Caesarean section is associated with various maternal and neonatal morbidities. With the alarming rise in Caesarean Section rate, these complications invariably increase. We conducted this study to assess the maternal and neonatal morbidities associated with CS in a tertiary care hospital in Andaman and Nicobar Islands, India. Methods: This was a prospective observational study done over a period of one year from January 2018 to December 2018. Data was collected for all CS performed in this time period and was statistically analysed by MS Excel, frequency distribution tables and SPSS Software. Result: Over the study period of one year, there were total 2646 deliveries with caesarean rate of 38.51% and more than 75% of these were primary caesarean section. Almost three fourth (73.61%) were emergency CS. Intraoperative adhesions and extension of uterine incision were common intraoperative complications whereas PPH was the most common post-operative morbidity. Intra operative complications were more in cases of emergency CS. Conclusion: We found a high CS rate with a high percentage of primary caesarean section along with various complications. With advancement in better maternal and foetal monitoring in labour in a tertiary care centre, it is desirable to be able to provide a safer vaginal delivery to patients that promises a better obstetric future. The decision to perform a Caesarean delivery must be chosen carefully, balancing risks and benefits, and not liberally. This is only possible if standard guidelines and protocols of management are in place at national and institutional levels. Only then the overall primary CS rate and its complications can best be avoided.