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Indications for cesarean deliveries in Norway,☆☆

https://doi.org/10.1067/mob.2003.217Get rights and content

Abstract

Objective: The purpose of this study was to investigate the indications for cesarean deliveries in Norway, related to type of operation, parity, and gestational age. Study Design: This was a prospective survey that used information provided by clinicians at 24 maternity units. Two thousand seven hundred seventy-eight cesarean deliveries were included, which represents 69.7% of all cesarean deliveries in Norway during the study period. Results: The cesarean delivery rate varied by maternal and gestational age, parity, and hospital of delivery. Seven indications accounted for 77.7% of the operations: fetal stress (21.9%), failure to progress (20.7%), previous cesarean delivery (8.9%), breech presentation ≥34 weeks of gestation (8.4%), maternal request (7.6%), preeclampsia (6.2%) and failed induction (4.0%). Of the total deliveries, 64.3% were emergency operations. Conclusion: Accurate information about indications for cesarean deliveries in Norway has been obtained. Two thirds of all deliveries were emergency operations; the most important indications were fetal stress and failure to progress. In the elective cesarean delivery group, the two most important indications were previous cesarean delivery and maternal request. (Am J Obstet Gynecol 2003;188:864-70.)

Section snippets

Material and methods

All maternity units in Norway, with an expected number of at least 500 deliveries per year, were invited to participate in the survey. Twenty-four of 26 units accepted, which represented 70.9% of 34,084 births (n = 24,157) and 69.7% of 4721 cesarean deliveries (n= 3289) in Norway during the project period.

Ten of the participating units usually have >2000 births per year, and nine of the units usually have between 1000 and 2000 births.

The project period was from December 1, 1998, to July 1,

Data from the mbrn

The overall cesarean delivery rate in Norway during the study period was 13.9% and, among participating departments, was 13.6% (range, 8.8%-21.8%). Seventeen maternity units had a cesarean delivery rate between 11.6% and 15.6%, 3 units had a rate of <11.6%, and 4 units had a rate of >15.6%. The number of deliveries and cesarean delivery rates that were related to parity, previous cesarean delivery, gestational age, and maternal age are given in Table II.

. The number of all deliveries (n = 24,157)

Comment

The present prospective study gives detailed information on indications for cesarean deliveries in Norway. It describes two thirds of all cesarean deliveries in Norway during the survey period. The obstetrician who was responsible for making the decision to perform the cesarean delivery or who performed the delivery had to fill out a comprehensive form that described the cesarean delivery.

Prespecified indications were listed; priorities had to be stated in cases in which >1 indication was

Acknowledgements

The authors thank the Norwegian Medical Association for organizational and financial support.

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    Supported by the Norwegian Medical Association.

    ☆☆

    Reprint requests: Toril Kolås, MD, Department of Obstetric and Gynecology, Lillehammer County Hospital, N-2629 Lillehammer, Norway.

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