Table 4.
Probability of caesarean section given selected pregnancy and intrapartum conditions
| |
Former East Germany |
Former West Germany |
By year |
By region |
||||
|---|---|---|---|---|---|---|---|---|
| |
2004a |
2005 |
2006f |
2004a |
2005 |
2006f |
|
|
| Diagnosesb | % | % | % | % | % | % | p-valuee | p-valuee |
| Twins and higher order pregnancies |
71.85 |
71.38 |
68.28 |
75.30 |
74.42 |
74.34 |
0.3512 |
0.0118 |
| Anomalies of the fetal presentation |
76.72 |
74.41 |
75.83 |
79.15 |
79.56 |
78.83 |
0.4934 |
<.0001 |
| Intrauterine growth restriction |
47.96 |
44.55 |
42.88 |
52.91 |
51.58 |
50.67 |
0.0259 |
<.0001 |
| Post date pregnancy |
18.58 |
17.88 |
19.96 |
24.73 |
24.96 |
25.80 |
0.0303 |
<.0001 |
| Preterm delivery |
50.49 |
46.55 |
46.63 |
54.25 |
54.34 |
55.44 |
0.7540 |
<.0001 |
| Maternal distress |
46.67 |
39.33 |
45.22 |
57.63 |
60.29 |
55.81 |
0.6702 |
<.0001 |
| Obstructed labour |
54.01 |
52.51 |
49.40 |
53.54 |
54.39 |
54.73 |
0.8577 |
0.3510 |
| Asphyxia |
31.08 |
29.07 |
29.75 |
36.92 |
36.54 |
37.24 |
0.9664 |
<.0001 |
| Prolonged birth |
44.84 |
45.66 |
50.08 |
48.84 |
49.63 |
50.60 |
0.0030 |
0.0009 |
| Macrosomia |
48.82 |
45.97 |
46.58 |
54.38 |
57.74 |
48.67 |
0.0014 |
0.0011 |
| Placenta praevia |
93.22 |
82.19 |
82.50 |
87.95 |
86.68 |
87.47 |
0.3814 |
0.4586 |
| Abruptio placentae |
87.65 |
85.86 |
82.28 |
84.28 |
86.68 |
86.85 |
0.5091 |
0.8071 |
| Disproportion |
80.59 |
79.42 |
80.00 |
83.23 |
82.10 |
81.98 |
0.2338 |
0.0476 |
| Anomalies of maternal pelvis |
64.46 |
67.41 |
69.80 |
77.69 |
78.74 |
78.79 |
0.0023 |
<.0001 |
| Intrapartal bleeding (excluding placenta praevia) |
52.73 |
64.15 |
50.67 |
51.55 |
50.11 |
57.18 |
0.1732 |
0.5729 |
| Failed induction |
63.80 |
70.30 |
71.07 |
82.11 |
86.05 |
86.88 |
0.0029 |
<.0001 |
| Preexisting hypertonic disorders |
49.21 |
41.56 |
49.30 |
63.25 |
52.06 |
54.40 |
0.0932 |
0.0115 |
| Non-severe hypertonic disorders during pregnancy |
38.85 |
36.15 |
36.57 |
48.93 |
47.59 |
48.01 |
0.3590 |
<.0001 |
| Preeclampsia |
57.39 |
50.85 |
57.12 |
61.49 |
63.40 |
65.15 |
0.0278 |
<.0001 |
| Eclampsia |
67.86 |
57.14 |
57.14 |
68.75 |
77.14 |
69.15 |
0.8089 |
0.1219 |
| Complications because of umbilical cord |
16.06 |
15.25 |
17.48 |
18.79 |
18.78 |
20.04 |
0.0254 |
<.0001 |
| Diabetes mellitus |
50.00 |
55.07 |
58.49 |
60.21 |
56.70 |
59.79 |
0.7618 |
0.2409 |
| Gestational diabetes mellitus |
32.60 |
33.83 |
34.09 |
41.21 |
40.99 |
42.09 |
0.4453 |
<.0001 |
| Uterine rupture |
93.10 |
88.89 |
94.12 |
89.10 |
88.73 |
91.94 |
0.3597 |
0.5007 |
| Premature rupture of foetal membranes (PROM) |
21.98 |
19.04 |
19.66 |
24.97 |
25.03 |
25.21 |
0.6226 |
<.0001 |
| Abnorm contractions |
18.19 |
13.91 |
18.27 |
19.00 |
17.37 |
17.10 |
0.0618 |
0.1223 |
| Previous caesarean section |
68.94 |
71.18 |
76.32 |
80.64 |
81.15 |
82.45 |
0.0003 |
<.0001 |
| At least one strongc indication for caesarean section |
77.96 |
75.51 |
76.71 |
80.32 |
80.31 |
79.86 |
0.2480 |
<.0001 |
| At least one of the moderated indications for caesarean section |
20.78 |
19.62 |
20.77 |
28.40 |
28.63 |
29.28 |
0.0080 |
<.0001 |
| Patients with no indication of diagnoses which could justify caesarean section | 4.04 | 4.26 | 4.82 | 8.17 | 7.91 | 8.19 | 0.5343 | <.0001 |
a Restricted to data from February till December.
b The same patient could have several of the listed diagnoses.
c As strong indications were classified: Placenta praevia, Abruptio placaente, uterine rupture, anomalies of foetal presentation and disproportion [11].
d All indications listed in the table and not classified as strong were classified as moderate.
e p-values obtained from logistic regression mutually adjusting for time trends and regional differences.
f Restricted to births from January till November.