Trend in cesarean section rate.

OBJECTIVE To investigate factors influencing the increase in cesarean section CS rates, and to implement control measures. METHODS This retrospective analysis reviewed the birth registry of the Department of Obstetrics and Gynecology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia. We compared the frequency of different indications for CS between January 2007 and December 2008. The numbers of CS studied were 1105 in 2007, while they were 1226 in the year 2008. Thus, the sample size studied was 2331 cesarean deliveries. Approval of the ethical committee for publication was obtained. RESULTS The CS rate exceeded the acceptable 15% rate suggested by the World Health Organization (WHO) at our institution, and probably in many other hospitals in Saudi Arabia. Fetal distress, previous single CS, previous multiple CS, and breech presentation were the most common indications for CS. CONCLUSION This high rate of CS will continue to increase due to the tendency to have large families, and the self-perpetuating character of each CS. Efforts should be made at each hospital level, and nationwide, to control this tendency.