Retrospective analysis of cesarean section rates in reproductive-aged women in the Kyrgyz Republic
Objective. To assess current cesarean section (CS) birth trends in pregnant women in the Kyrgyz Republic (KR) in order to develop activities of applied significance and to provide their scientific substantiation.Samigullina A.E., Kibets E.A., Vybornykh V.A.
Material and methods. This study used data from the annual reports of the Republican Medical Information Center, Ministry of Health of the KR, over 2005-2015. To estimate CS rates, the time series were analyzed in terms of absolute growth indicators, visibility index, growth rate, and 1% incremental value; the dynamic series was equalized calculating the moving average and using the interval coalescence method. CS delivery rates to births (100%) and M±m (per 1,000 births) were estimated. Maternal deaths per 100,000 live births were calculated. Perinatal mortality rates per 1,000 live and still births were determined. The investigators calculated correlation and determination coefficients, Student’s test and McNemar’s test to assess the shape, closeness, reliability of a correlation between CS rates and maternal and perinatal deaths.
Results. The rate of CS in the KR over the past eleven years has steadily increased by 2.9 times (p < 0.001). There is an inverse, strong, and significant correlation between the increased cesarean birth rates and maternal and perinatal mortality. This period in Bishkek is marked by a 2.4-fold rise in CS rates (p < 0.001). In the KR, there was a significant (2-fold) percent increase in CS rates as compared to vaginal deliveries (p < 0.001). The CS/birth ratio ranks first in the self-sustained republican organizations of Bishkek. In the Naryn region during the analyzed period, the CS/birth ratio increased 4.4-fold (p < 0.001), which is 1.5 times higher than the republican values.
Conclusion. The scientific evaluation of findings requires the rethinking of indications and the elaboration of CS rates to significantly decrease maternal and perinatal deaths in the country.
Keywords
Supplementary Materials
- Table 1. The frequency of cesarean section in the Kyrgyz Republic for the period 2005-2015.
- Table 2. Correlation dependence of caesarean section to the level of maternal and perinatal mortality in the Kyrgyz Republic
- Figure. The dynamics of the level of maternal mortality (per 100,000), perinatal mortality (per 1,000), labor by cesarean section (% of births) in the Kyrgyz Republic for the period from 2005 to 2015.
References
1. Айламазян Э.К., Новиков Б.Н., Зайнулина М.С., Палинка Г.К., Рябцева И.Т., Тарасова М.А. Акушерство. СПб.: Спец.Лит; 2010. 543с. [Aylamazyan E.K., Novikov B.N., Zaynulina M.S., Palinka G.K., Ryabtseva I.T., Tarasova M.A. Obstetrics. St. Petersburg: Spets.Lit; 2010. 543p. (in Russian)]
2. Манухин И.Б., Мурашко А.В., Мынбаев О.А. Повторное кесарево сечение с хирургической позиции: системный обзор. Журнал акушерства и женских болезней. 2011; 60(Спецвыпуск): 69-70. [Manukhin I.B., Murashko A.V., Myinbaev O.A. Repeated cesarean section from surgical position: systemic review. Zhurnal akusherstva i zhenskih bolezney. 2011; 60(Special issue): 69-70. (in Russian)]
3. Чернуха Е.А. Родовой блок. Руководство для врачей. М.: Триада-Х; 2005. 712с. [Chernuha E.A. Family block. A guide for doctors. Moscow: Triada-H; 2005. 712p. (in Russian)]
4. Краснопольский В.И., Долгиева Л.У. Место кесарево сечения при родоразрешении женщин с одноплодной беременностью после ЭКО. Журнал акушерства и женских болезней. 2010; 59(5):103-9. [Krasnopolskiy V.I., Dolgieva L.U. Place of cesarean section at delivery of women with single-pregnancy after IVF. Zhurnal akusherstva i zhenskih bolezney. 2010; 59(5):103-9. (in Russian)]
5. Телегина И.В. Оптимальная частота оперативного родоразрешения в современных условиях. Вестник Российского государственного медицинского университета. 2010; (Спецвыпуск 2): 287. [Telegina I.V. The optimal frequency of surgical delivery in modern conditions. Vestnik Rossiyskogo gosudarstvennogo meditsinskogo universiteta. 2010; (Spetsvyipusk 2): 287. (in Russian)]
6. Самигуллина А.Э., Выборных В.А. Кесарево сечение: история и проблемы современности. Известия ВУЗов Кыргызстана. 2015; 7: 43-5. [Samigullina A.E., Vyibornyih V.A. Cesarean section: history and problems of modernity. Izvestiya VUZov Kyirgyizstana. 2015; 7: 43-5. (in Russian)]
Received 09.03.2017
Accepted 24.04.2017
About the Authors
Samigullina Alfiia, Doctor of Medical Sciences, Senior Researcher, professor of the Department Obstetrics, Gynecology and Reproduction, Kyrgyz StateMedical Institute of retraining and advanced training. 720040, Kyrgyz Republic, Bishkek, Bokonbaeva str. 144а. Tel.: +996 773 877778. E-mail: samigullina.68@mail.ru
Kibez Elena, Candidate of Medical Sciences, assistant professor of the Department Obstetrics, Gynecology and Reproduction, Kyrgyz State Medical Institute of retraining and advanced training. 720040, Kyrgyz Republic, Bishkek, Bokonbaeva str. 144а. Tel.: +996 707 404706. E-mail: kib-elena2003@yandex.ru
Vybornyh Violetta, graduate student of the Department Obstetrics, Gynecology and Reproduction, Kyrgyz State Medical Institute of retraining and advanced training.
720040, Kyrgyz Republic, Bishkek, Bokonbaeva str. 144а. Tel.: +996 555 325526. E-mail: doctor-vybornyh@mail.ru
For citations: Samigullina A.E., Kibets E.A., Vybornykh V.A. Retrospective analysis of cesarean section rates in reproductive-aged women in the Kyrgyz Republic. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (12): 104-9. (in Russian)
https://dx.doi.org/10.18565/aig.2017.12.104-109