A review of primary caesarean sections in Tasmania.

In the years 1975-1982 inclusive there were 55,095 deliveries in Tasmania and of these 2,738 patients (4.9%) were delivered by primary Cesarean section. The primary Caesarean section rate increased from 4.3% in 1975 to 6.6% in 1982. This increase has been due to the increased incidence of primary Caesarean section associated with breech presentation and to a lesser extent fetal distress. Although the overall perinatal mortality rate fell from 19.5 per 1,000 births in 1975 to 10.8 per 1,000 births in 1982, there has been no corresponding fall in the perinatal mortality rate associated with primary Caesarean section. As an increase in Caesarean section will lead to an increase in maternal mortality and morbidity it is considered that an active review of the reasons for the rise in Caesarean section should be undertaken by those hospitals where the rate is unusually high.