[Changes in indication for caesarean section analysis of 1241 caesarean sections (author's transl)].

On the basis of a large schema of indications (tab. 1, 2) 1241 Caesarean sections during 1966-1973 are analysed. The following points can be summarized: 1) The percentage rose from 6.4% (1966) to 10.75% (1973) (Fig. 1). 2) The percentage of Caesarean sections decided on for the sake of the child rose from 54% (1966/67) to 63.9 (1972/73) (tab. 3). 3) Vital indications fell due to increasingly preventive obstetrics from 71.7% (1966) to between 30% and 41.3% (1973) (tab. 4). 4) Perinatal mortality of 1258 children delivered by Caesarean section was 4.05% (tab. 5). Of Children delivered surgically for vital indications 6.1% died, of those delivered surgically for preventive indications only 0.9% died in the perinatal period (tab. 6). 5) This shift from the vital towards preventive indication is particularly pronounced for repeated Caesarean section (tab. 7) and for breech presentation (tab. 8). 6) Maternal mortality after Caesarean section reached 3.2%, after spontaneous delivery only 0.16%. This great difference in the maternal risk between those treated with Caesarean section and those with spontaneous delivery emphasizes the need for indications for Caesarean section which are critical, conscious of the responsibility and not too generous.