Is the high frequency of Caesarean sections in a highly specialized gyneco-obstetric hospital justifiable?

To determine if the high proportion of cesarean section performed at Obstetrics and Gynecology number 3 Hospital of the Medical Center "La Raza", IMSS (HGO3) is justified. We carried out a cross sectional study of 300 patients who underwent cesarean section during a period of 35 consecutive days, from October to November 2001. We reviewed their clinical expedients and went to additional direct interrogatory. The studied variables were the number and indications of cesarean section; if they were programmed or urgent events and if the indication of surgery was related with perinatal outcome. We used descriptive statistics with frequencies and percentages in statistics program SPSS10. We found high incidence of prematurity (38.3%), pregestational and gestational maternal diseases (66%) and urgent indication of surgery (60.7%). The incidence of cesarean section in similar third level concentration hospitals in this country ranks from 20 to 40%. At HGO3 it was 72.51% in the last year (2001). This suggests that pregnancy comorbidity seen at this hospital, may be proportionally larger than in other similar units, because two thirds of patients had a high risk pregnancy and, if not, they had an obstetric or fetal justification for cesarean section in 80% of cases.