Determinantes relacionados ao parto cesáreo em maternidade pública da Região Metropolitana de Belo Horizonte-MG

Abstract

Introduction: Brazil has a cesarean rate of approximately 50% while the World Health Organization considers rates above 15% difficult to be justified from a medical standpoint. Objective: To evaluate the prevalence, indications and the determinants of cesarean in an institution of Vespasiano city. Methods: Cross-sectional study, with medical records analysis, from a Vespasiano’s hospital, from August 2012 to October 2013. Results: By analyzing 82 medical records, using the proposed variables and comparing them between women who underwent vaginal delivery and those who underwent cesarean section, the prevalence of cesarean was 63.41% and its main indications were cephalopelvic disproportion (42.31%), one previous cesarean (17.31%) and post-term pregnancy (17.31%). Robson classification was used to evaluate the cesarean rate and group 2 (nulliparous, single cephalic fetus, term, with induced labor or cesarean delivery without labor) was the largest contributor to this rate, with 26.83% of cesareans. Comparatively with vaginal delivery, the determinants for cesarean section were the presence of previous cesarian section (p=0.04), absence of labor (p=0.000) and intact amniotic sac at admission (p=0.002). Conclusion: The prevalence of cesarean section at the institution evaluated was four times superior than the recommended by the World Health Organization. A significant proportion of cesarean deliveries could be avoided if the recommendations validated by the literature were applied in conducting the delivery.