PROPORTION OF CEASEARN SECTION AND ASSOCIATED FACTORS AMONG MOTHERS WHO ATTENDED DELIVERY FROM 2013 -2017 IN DEBARK DISTRICT HOSPITAL, NORTH WEST ETHIOPIA 2019.

Abstract

Background: Cesarean section (CS) is a surgical intervention, which is carried out to ensure the safety of mother and child when vaginal delivery is not possible. But it is associated with an increased morbidity and mortality among delivering mothers and infants when compared to vaginal deliveries. The rate of CS is increasing in both developing and developed countries despite the World Health Organization recommendation of 5% to 15% as an optimum range. Cesarean section indications vary among different populations and countries. There is no world standard classification system for indications of cesarean section. Objective: To assess the proportion of cesarean section and associated factors among mothers who attended delivery in Debark district Hospital from 2013 to 2017. METHODES:-Cross sectional study was conducted by reviewing medical records. Sample size by using single population proportion formula was 800 but the final sample size was 751 because the rest samples were incomplete and excluded. Systematic random sampling technique was used to select study participants. The checklist was used for data collection by adopting from other articles. The data was entered into EPI info 7.0 and exported to SPSS version 20 then analyzed. Binary logistic regression was done. Odd ratio was used for interpretation of strength of association of independent and dependent variables. For statistical significance tests, cut- off value set as p<0.05 with CI of 95%. Results: The proportion of cesarean section in this study was 23.6% (95%CI, 20.5% - 26.6%).The leading indications for CS were non reassurance fetal heart rate 40 (22.6%) followed by cephalopelvic disproportion 33(18.6%).Caesarean section was higher among mothers whose labor is induced (AOR: 2.925, 95% CI: 1.240, 6.901), and who are referred from other institutions (AOR: 0.329, 95% CI: 0.208, 0.519).CS is also positively associated to fetal weight. (AOR: 4.717, 95% CI: 1.417, 15.708) Conclusion and Recommendation: Compared to WHO recommendation the proportion of CS in this study was high. Condition of referral, induction of labor and fetal weight are associated with cesarean delivery. Conservative management of fetal distress and close follow up of induced labor may reduce unnecessary cesarean section Key words: Proportion, associated factors, cesarean section