The factors that effect indications of caesarean section, distribution of caesarean section indications and examination of vaginal delivery in Gazi University School of Medicine, Department of Obstetrics and Gynecology between years from 1988 to 2009

The aim of this study was to analyses of all deliveries in Gazi University School of Medicine, Department of Obstetrics and Gynecology between years from 1988 to 2009. In addition; rate, indications, effecting factors, chage in time, rate in Turkey and World and suggestions for decreasing the caesarean section rate are the other aims of this study.Between 01.01.1988 and 30.01.2009 patients who apply and deliver a birth in Gazi University School of Medicine, Department of Obstetrics and Gynecology Clinic were evaluated retrospectively from birth records. 21414 vaginal and abdominal births were evaluated from this records. Data were evaluated in SPSS 15.0 programme. For qualitative data analyeses % distribution, for quantitative data mean +/- SD, for comparing qualitative data Chi-square test, for comparing qualitative data t-test and variance analyses and nonparamatric methods of these tests were used.In this study, rate of caesarean section in Gazi University School of Medicine, Department of Obstetrics and Gynecology Clinic was found as 41.8 %. It is observed that this rate is higher than both Turkey (2008-36,7%) and USA (2007-31,8%). In our clinic caesarean section was performed because of 43,1% elective, 26,2% repetative, 11,9% cephalo pelvic disproportion, 6,4% breech presentation, 4.2% acute fetal distress, 3.7% multiple gestations. It is observed that the distribution of elective and repetative caesarean sections percentages are progressively increased in years. 45-60% of all caesarean sections was elective after the year of 1999. In all delivery modes, after twenty weeks of gestation at singleton deliveries 93.4% cephalic, 4.9% breech and 0.8% other presentations (transverse situs, obliq situs, compound presentation) observed. In vaginal delivery (total 12457 cases), 97.2% nonoperative, 2.8% operative prosedure was performed ( 1.8% forceps, 1.0% vacuum extraction). In vaginal delivery, % 78,8 local anesthesia, % 2,9 epidural anesthesia, % 0,7 combined anesthesia, % 0,6 spinal anesthesia were used, in % 17 of vaginal deliveries no anesthesia were used. In vaginal deliveries local anesthesia were most preferred and spinal anesthesia were least preferred methods. In our clinic increasing usage of local anesthesia in vaginal deliveries observed in last 21 years especially after 2004. Allocating sufficient time for prenatal pregnant education, generalizing local ansthesia technics would be effective for overcoming pregnants delivery fears. As a result; the primary aim must be education of public for decreasing caesarean section rate .Key words; Caesarean section rate, Elective caesarean section, Delivery mode