Caesarean-sections in Romania between 1990-2013: a statistical analysis
A.A. Simionescu, E. Marin
Rezumat: A delivery by Caesarean-section (C-section) is done in case of: low-lying placenta (placenta praevia central), cephalo-pelvic disproportion and malpresentations (e.g., transversal presentation during labor); C-sections delivery on maternal request were performed last years. Nowadays, there are more surgical delivery than recommended numbers, most of them before the due date (premature deliveries) following the fetal conditions prenatal diagnosed by maternal-fetal specialists, since chronic intrauterine hypoxia of the fetus and severe placental insufficiency with Doppler abnormalities, fetal anemia, fetal tumors or other fetal malformations requiring complex management. In 2010, according to the World Health Organization report, Romania has shown a rate of C-sections to 30.4% by live births, comparing with Germany with a rate of 30.3%, Hungary with a rate of 32.5% and Austria - 28.9%. At the opposite, there are countries with optimal rates of birth by C-sections, respecting WHO recommendations like: Finland (16.1%), Norway (17.3%) and Croatia (18.7%). The aim of the current study was to analyze the trend of the C-section in Romania. Furthermore, we wanted to describe the evolution of the main indicators of natality. A statistical descriptive study of the data of deliveries in Romania between 1990 and 2013 obtained from the Romanian National Centre for Statistics was conducted. A total of 5.56 millions of births (live and death-births) in a 24-year period were analyzed. The study started in 1990 - the first year after the fall of Ceaușescu’s communist period, that was characterised by the few changes in the medical practices. There was a 7-time fold increase in Caesarean delivery rate in the analyzed period. In 1990, the rate of surgical births by C-sections was 4.99%, comparing with a rate of 34.15% C-sections in 2013. We have reported an upward trend and we have analyzed this trend by the geographical area, urban versus rural. The study shows that Romania followed the worldwide upward trend of the numbers of C-sections. This increased trend of delivery by C-sections raises a number of medical and financial aspects and are expected to determine changes for patient care, fetus and society. Cuvinte cheie: cesarean-section, Romania, birth rate, statistics.