TitleCaesarean delivery rates, determinants and indications in Makassed Hospital, Jerusalem 1993 and 2002
Publication TypeJournal Article
Year of Publication2009
AuthorsMikki, N, Rmeileh, A, Wick, L, Abu-Asab, N, Hassan-Bitar, S
JournalEast Mediterr Health J
Date PublishedJul-Aug
ISBN Number1020-3397 (Print)<br/>1020-3397 (Linking)
Accession Number20187538
Keywords*Hospitals, Teaching, *Patient Selection, Adolescent, Adult, Breech Presentation/surgery, Cesarean Section/*trends, Chi-Square Distribution, Female, Fetal Distress/surgery, Health Services Research, Humans, Hypertension, Pregnancy-Induced/surgery, Logistic Models, Medical Audit, Middle East, Parity, Physician's Practice Patterns/*trends, Pregnancy, Socioeconomic Factors, Unnecessary Procedures/trends

This study investigated the rising rate of caesarean section (CS) deliveries between 1993 and 2002 (9.4% to 14.4%) and associated factors, including indications for CS and sociodemographic and clinical characteristics based on the register of a major Palestinian teaching hospital. Instrumental deliveries declined from 12.6% to 4.4%. Fetal distress decreased as an indication for CS, while previous CS and breech presentations contributed to the increase. Decision-making for CS needs to frame the benefits and risks of the intervention within the context of women's entire reproductive life-cycle and existing standards of care, avoiding unnecessary and costly CS deliveries to reduce iatrogenic complications and conserve resources.