ABSTRACT
The objective of this paper is to evaluate the influence of patient risk status on
the incidence of and indications for cesarean delivery. All live births ≥23 weeks
at the University of Vermont in 1995 (n = 2395) were retrospectively analyzed for delivery route, indication for cesarean,
gestational age, parity, and practice group (to reflect risk status). The total cesarean
rate was 14.4% (344 of 2395), and the primary rate was 11.4% (244 of 2144). Abnormal
presentation was the most common indication (25.6%, 88 of 344). The “corrected” cesarean
rate (maternal-fetal medicine and transported patients excluded) was 12.4% (273 of
2194), and the “corrected” primary rate was 9.6% (190 of 1975). Furthermore, when
all deliveries were analyzed, regardless of risk status but limited to gestational
age ≥36 weeks, the rates did not change (12.6%, 280 of 2214; primary 9.2%, 183 of
1994). Arrest of dilation was the most common indication in both “corrected” subgroups
(23.4 and 24.6%, respectively). Cesarean rates at tertiary care hospitals should be
compared with rates at community hospitals only after correcting for dissimilar patient
groups or gestational age.
Keywords
Cesarean - corrected cesarean rates - tertiary care
