Cesarean section and perinatal mortality. A nine-year experience in a city/county hospital.

Presented is an analysis of experience from July, 1973, through June, 1982, in a teaching institution that served a high-risk urban population. The suggestion is made that improvement in perinatal mortality does not necessarily rely upon an ever-increasing cesarean section rate. During the 9 years encompassed by the study, the total cesarean section rate ranged from a low of 5.8% to a high of 8.2%. The primary cesarean section rate was first recorded separately in 1976, and stayed between 3.2% and 4.9%. During the same span of time, the uncorrected Perinatal Group II mortality rate dropped from 35/1,000 to 18/1,000. An attempt is made to interpret the various factors involved in accomplishing these results.