STUDY ON RISING TREND OF CAESAREAN DELIVERY IN BANGLADESH DURING LAST FEW DECADES

Dr. Haripada Debnath*, Dr. Zahirun Nessa, Dr. Nargis Sultana and Dr. Begum Shaira Sharifa

ABSTRACT

Background: During last 1990 decade there were death of huge number of pregnant mother due to pregnancy related multiple complications like post partum and antepartum hemorrhage, abortion specially septic, preeclampsia, Eclampsia, Obstructed labour, Rupture Uterus and Septicemia etc. On 1990 to achieve our Millenium Development Goal (MDG) we had to reduce maternal mortality Rate (MMR) from 574 per 100000 Live Birth at 1990 to 480 per 100000 Live Birth at 2000 and 194 per 100000 Live Birth at 2010. For that reason Bangladesh Government initiated a Emergency Obstetric Care (EOC) Project which was Implemented In Bangladesh at Union sub centre and community clinic, Upazilla Health Complex, District Sadar Hospital, Maternity Clinic and Medical college hospital. As a Result Caesarean section delivery was increased from 2 % at 1993 to 6 % at 2004 were found on Survey conducted by Demographic and Health Survey, Bangladesh. Considering safe delivery and reducing maternal and Infant mortality Caesarean section facilities is increasing day by day at Upazila and Distract level in both Government Hospital and Non-Government Clinic. Caesarean section delivery was increased from 30 % at 2000 to 60 % at 2014 of total institutional delivery: Objective: My study aimed to assess the indications and find out the causes of rising trend of Caesarean section over last 7 years from 2012 to 2018 and find out the way to decrease this rising trend: Method: It was a retrospective observational study of pregnant women admitted at Upazilla Health Complex Bhairab Kishoreganj from 2012 to 2018 for their delivery either Vaginal or Caesarean section. There were comparative study of Vaginal and Caesarean Delivery and different indications of Caesarean section in these years. Result: My study on pregnant women admitted at Upazilla Health Complex Bhairab Kishoreganj for delivery either Vaginal or Caesarean Section in the year of 2012 to 2018. My Study Shows Vaginal delivery is 53.77% of total delivery at 2012 which is gradually decreasing to 45.09 % at 2016. Afterwards Vaginal delivery is increasing up to 52.06% at 2017 and 50.03% at 2018. On the other hand Caesarean section is increasing from 46.13% at 2012 to 54.10 % at 2016. of total delivery at Upazilla Health Complex. It does not Indicate the rate of Caesarean section on over all delivery occured in Bhairab Upazila and surroundings but there is rising trend of Caesarean section. There were variations of different indications of Caesarean section at between 2012 and 2018. Caesarean section were done for previous caesarean section was 34.67% at 2012 and 57.01 % at 2018. Caesarean section were done for maternal request was 17.47% at 2012 and 7.53 % at 2018. Day by day maternal request for Caesarean section was decreasing because of increasing patients morbidity and treatment cost whereas Caesarean section is increasing for previous Caesarean section because of safe mother, safe newborn child and lack of intensive care and facilities for post Caesarean Vaginal delivery.

Keywords: Caesarean section, Vaginal Delivery, Maternal mortality, Maternal Morbidity.