Cesarean section rates and indications in Greece: data from a 24-year period in a teaching hospital

To assess the overall cesarean section rates and indications in a Greek teaching hospital over a period of 24 years. Data from 34,575 deliveries between 1977 and 2000 were reviewed. Analysis of cesarean section rates and indications followed. The overall cesarean section rate increased progressively from 13.8% (1977-83) to 29.9% (1994-2000). Cesarean section rates due to previous cesarean delivery increased from 7.7% of all deliveries (1977-83) to 10.9% (1994-2000). Primary cesarean section rates increased more than three-fold from 6.1% (1977-83) to 19% (1994-2000). The main indications for primary cesarean section were: dystocia (including dysfunctional labor, cephalopelvic disproportion and malpresentations), fetal distress, breech presentation, and hypertensive disorders of pregnancy. The overall cesarean section rate increased more than two-fold over the study period. Previous cesarean section was the most common indication. However, the overall increase is mainly to increase of primary cesarean section rates.