Is it possible to reduce the rates of caesarean section?
The objective. Determination of indications to caesarean section and finding of possible ways to reduce the rates of this surgery. Patients and methods. A retrospective study of 1752 medical histories of labour of pregnant women who gave birth by caesarean section in the maternity unit of Moscow City Clinical Hospital No 7. Results. The total prevalence of caesarean section among all childbirths was 29.9%, of them 26.1% of operations were planned, 57.2% - emergency, 16.7% - urgent. Only 8.05% of pregnant women gave birth by caesarean section due to absolute indications (an anatomically narrow pelvis grades 3-4, placental presentation, eclampsia, placental abruption of a normally located placenta, a clinically narrow pelvis). In other observations, caesarean section was performed to due the sum total of relative indications. The main indications to operative delivery were as follows: a uterine scar after caesarean section (15.6%), extragenital pathology (132%), labour abnormalities (12.9%), fetal hypoxy (11.8%), pelvic presentation (8.16%), prematurity (5.88%). Conclusion. Reduction of the rates of caesarean section is possible at the expense ot decreasing the number of primary caesarean sections in healthy primiparous women above 30 years of age or multiparous women with a long interval between pregnancies in case of their timely preparation to childbirth, in infertile patients, whose pregnancy occurred naturally and went on without complications, and also after IVF due to male factor infertility. In total, a reserve for reducing the rates of caesarean section was only 5.5%.