Maternal Outcomes Associated with Caesarean versus Vaginal Delivery

Abstract

Introduction: To choose the best mode of delivery (vaginal versus caesarean section) still remains a contentious issue. Caesarean section is a major abdominal surgery with its related medical, anesthetic and surgical complications. Maternal mortality and morbidity is higher in caesarean section compared with vaginal delivery. The most common causes of maternal mortality during caesarean section are due to anesthesia, bleeding and infection.

Aim: The aim of this study was to determine the mode of delivery and maternal outcomes in Sanandaj's hospital, Iran, during one year.

Materials and methods: The study population included all women who were admitted for delivery in Sanandaj's Hospital. Data collection instrument was a researcher made questionnaire. Data were entered into SPSS version 20.0 and analyzed using Chi-square test. Desired outcomes were entered into multiple logistic regression models. For estimating the parameters and increasing the level of significance we used bootstrap to generate 1000 samples.

Results: During the study, a total of 5984 deliveries were conducted in Sanandaj Hospital, of which 3423 (57.20%) were vaginal (vaginal, vaginal + episiotomy, instrumental delivery) and 2561 (42.80%) were caesarean section. The results showed a statistically significant association between delivery mode and demographic variables such as age, occupation and level of education; whereas, no significant association was found between place of residence and parity.

Conclusion: The finding of this study showed that caesarean section delivery rate in Sanandaj was 42.80% in 2012-2013 which is higher than caesarean section rate recommended by WHO. Also, there was a relationship between mode of delivery and maternal outcomes.

Keywords: Bleeding; Hysterectomy; Perineal laceration; Uterine rupture.