All the patients age, weight pulse rate, blood pressure, respiratory rate were recorded. Mother’s obstetrics history (13) was also recorded in a pre drawn proforma. The observations thus collected were tabulated and analyzed.

OBSERVATIONS:

On analysis of the collected data of eighty five mothers under gone C. S., it has been revealed that the various parameters recorded from mothers undergone caesarean section in two groups under study (Study and Control). The study group’s mean age was 32.74 years in comparison to the control group mean age 26.8 years with the age being comparable in study to control groups (Table – I) The mean weight was 54.7 Kgs. in study group in comparison to their counterparts 52.12 Kgs. in control group. The table further revealed that the mean gestation age was comparable in both the group and was 39.3 weeks to 39.6 weeks. As far as the mean gravida was concerned in these two groups (study and control) these were 2.95 to 2.11.in control and study group respectively. The table also shows that the mean pulse rate was comparable in study to control group being 95.88 and 92.12 per minutes. The mean arterial pressure was recorded in study and control group was 101.9and 94.38 mm of Hg respectively.

Table – I: Average preoperative data of mothers undergoing caesarean section

S. No.	Data	Study Group	Control Group
1	Age in year	32.74 ± 2.46	26.8 ± 2.46
2	Weight in Kg.	54.7 ± 2.97	52.12 ± 3.60
3	Gravidity	2.11 ± 1.25	2.95 ± 1.16
4	Gestational age	39.3 ± 1.59	3936 ± 1.38
5	Basal Pulse rate per minute	95.38 ± 14.15	92.12 ± 5.30
6	Mean arterial Pressure in mm Hg.	101.19 ± 10.19	94.38 ± 5.53

Table – II: Incidence of various indications in all the patients

S. No.	Indication	Study Group	Control Group
1	Previous section	33%	36%
2	Breech	13%	4%
3	C.P.D.	13%	24%
4	Non Progressive	11%	8%
5	Prolapse	6%	4%
6	Placenta previa	5%	12%
7	Others	16%	12%

[Table – II] The percentage of various indications for caesarean section in the study group and control group, many cases also had multiple indications. The highest percentage of cases had, previous section 33% as the indication for the caesarean section followed by Cephalo Pelvic Disproportion (C.P.D.) 13%, Breech, 13% Non progressive 11 % and Prolapsed genital cord and hand 6%, placenta previa 5% and cervical dystocia etc. 16% in study group while I n control group, previous section 36%, Breech 4%, C.P.D. 24%, Non progressive 8%, prolapse 4%, placenta previa 12% and other 12% .The other indications like cervical dystocia, Mitral stenosis, pulmonary hypertension, elderly primi, bad obstetric history and contracted pelvic were in the both group. It was further noted that 33% and 16 % of the cases were premigravida in both study control group respectively.

[Table – III] The occurrence of various presentations in the both group, Vertex was the most common presentation, being 75% of study group, 96% of the control group; Breech presentation represented 13% and 4% respectively in both the groups. Table further revealed that in study group 08 percent mothers who have undergone C.S. were because of Transverse Lie in comparision to none in their counter parts control group. Similarily in study group 02 % each mothers under gone C.S. because they have been diagnosed, Brow and Footling presentation again none in control group.

Table – III: Percentage incidence of various presentation in both groups

S. No.	Presentation	Study Group	Control Group
1	Vertex	75%	96%
2	Breech	13%	4%
3	Transverse lie	8%	-
4	Brow	2%	-
5	Footing	2%	-

DISCUSSIONS:

C. P. D. were the largest group (50 %) it includes grossly contracted pelvis, pelvis of normal shaoe in which some of the diameters are small, a pelvis of normal shape but size of the fetus was disproportionaly large and occipitoposterior position. There can be no disagreement about elective C. S. in cases of major degrees of disproportion are subjected to C. S. only after a proper trial of labour has been un-successful. All cases of persistent brow presentation at or above mid pelvic plane are best delivered by C.S. In only few cases of breech presentation C.S. is indicated. In 1960-61 in N.W.M. hospital less than 1 percent cases were delivered by C. S., the adage “once a C. S. always a C. S.”(11), this doctrine was established by Craigin in 1916. The incidence of C. S. is steadily rising. During the last decade there has been two to three fold rise in the incidence from the initial rate of about 10 % (12).The findings of the present study were more or less in accordance of the various studies carried out across the Globe by various authors.

A U. S. studies have revealed that babies born by C.S. have greater chance for respiratory problems. The Asia survey found that the procedure benefits babies during breech presentation. Reasons for elective C-sections vary globally, but increasing rates in many developing countries coincide with a rise in patients’ wealth and improved medical facilities (2). The vertex was the commonest presentation (81.11 %) which is in conformity with the established incidence of vertex presentation in pregnancy.

In Asia, some women opt for the surgery to choose their delivery day after consulting fortune tellers for “lucky” birthdays or times. Others fear painful natural births or worry their vaginas may be stretched or damaged by a normal delivery. Some women also prefer the operation because they mistakenly believe it is less risky.

“I think it’s safer for the mother and child to have C-sections and the relatives feel more secure because it’s very simple and very common now,”said a Vietnamese woman, Trang Thanh Van, 25, just days away from giving birth to her first child. “People worry that using tools to pull the baby out (in a vaginal birth) may affect their brains.”

China’s 46 percent C-section rate was followed by Vietnam and Thailand with 36 percent and 34 percent, respectively. The lowest rates were in Cambodia, with 15 percent and India, with 18 percent.

The study did not discuss specific reasons for the high number of C-sections, but it noted that more than 60 percent of the hospitals studied were motivated by financial incentives to perform surgeries (2).

As the capital’s largest maternity hospital (National Hospital of Gynaecology and Obstetrics in Hanoi, Vietnam), about 40 percent of the 20,000 babies delivered there annually are by C. S., according to Dr. Le Anh Tuan, the hospital’s vice director, who did not participate in the study. It receives the most complicated cases, with many women undergoing emergency surgery, but he said another reason is women with small frames whose babies are simply too large for them to deliver naturally.

Dr. Le said “the babies are bigger even than the Western countries,” he further added “Vietman was a country where we did not have enough food to eat; now we have a surplus of food. The mothers believe that if they eat a lot, their babies will be healthy”.

In Latin America .C.S. rates in all eight countries surveyed earlier by World Health Organization (W.H.O.) were thirty percent or even higher –similar to the U.S. rate. In Paraguay and Ecuador, 42 and 40 % of deliveries respectively were by C. S. It is further noted that some expectant mothers scheduled elective surgeries to avoid giving birth during holidays or even so they could attend parties ,according to Dr. Archana Shah, W. H. O. in Geneva, who worked on that report and cautioned that data in both studies represent a sample that may not reflect overall national rates.

Hanoi, Vietnam – nearly half of all birth in China are delivered by C.S., the world’s highest rate, according to a survey of W.H.O. –a shift towards modernization that is not necessarily a good thing. The U.N.health agency warned that the woom in unnecessary surgeries is jeopardizing women’s health (lancet) The report further revealed that unwanted C. S. are costlier than natural birth and raise the risk of complications for the mother. Report further added that C. S. have reached “Epidemic proportion “in many countries worldwide (2) Survey was conducted in nine Asian nations. The report revealed that the most dramatic findings in China where 46 % of births reviewed were C.S. - a quarter of them not medically necessary. In Beijing capital of China, according to Dr. He Yuanhua, who did not participate in the study, at Capital Antai Obsetrics and Gynaecology Hospital “So many expectant mothers asked for C.S., but we always suggest that they have a natural birth.” “It’s bad to have so many C.S. because natural birth is ideal one” In 2007 – 08, W. H. O. reviewed 110,000 births across Asia and found that twenty seven percent were carried out under knife, partially motivated by hospitals eager to make money (2). From above observations and discussions the authors reached to the conclusion that in the community there are some myths eg operation is less risky, because of the fear of the distress, pain and struggle during labour, because in rise in patients wealth ,some of the husbands think that after vaginal delivery sex pleasure may lessen ,because of lucky birthday’s or times, etc. some hospitals were motivated for financial gain and in India ,the medical reimbursement policy is also responsible up to some extent, but all these are jeopardizing women’s health, hence efforts must be made to bring awareness in the community because natural birth is the ideal way. Any C.S. is performed only in the interest of the mother and child – and that too after a careful evaluation.

ACKNOWLEDGEMENT:

The authors express their cordial thanks to Mr. Anand Singh Kanwar, Lab-Technician, Deptt. of Community Medicine, Govt. Medical College, Jagdalpur (C.G.) for his neat and excellent typing.

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Received on 26.04.2011

Accepted on 15.05.2011

Research J. Pharmacology and Pharmacodynamics. 3(3): May –June, 2011, 105-107