Introduction: In Italy the use of caesarean delivery has a rising trend moving away from European standards appeared on
Euro-Peristat on maternal and child health, presenting the highest percentage of use of this procedure with significant
regional differences. This study have analyzed the most recent data of a Sicilian reality about normal delivery and
caesarean sections carried out in a hospital situated in Messina (Italy).
Materials and methods: A total number of 1,573 medical records from 1st January 2011 to 31st December 2013 were
analyzed and data gathered were statistically examined to describe general and specific parameters of the sample making
use of Epi Info 7.1.4 software (CDC Atlanta – USA). Chi-square test was used to show any statistic differences among
studied population.
Results: Overall data showed that were carried out 38.27% of spontaneous deliveries, 7.06% of induced labor, and 54.67%
of caesarean deliveries. There were no significant statistical differences between recourse to caesarean section and vaginal
delivery in relation to nationality, age, level of education and/or work. The enrolled group, based on the parameters
examined, was divided into appropriate caesarean section, in 79.49% of cases, inappropriate in 7.20% (mother’s request)
and unjustified in 13.31% (with no indication, incomplete medical record). An examination of the anesthetic medical
records showed that the caesarean section was considered to be urgent in 31.74% of the cases; however in 17.92% of these
cases there is no information in the medical records justifying the use of emergency procedures.
Conclusion: The reported data from the study that we conducted, lead to medical-legal and juridical considerations,
especially as regards the use of caesarean delivery on the woman request. The complexity of the phenomenon requires the
development of a variety of intervention strategies, not only for issues related to the reduction of health care costs, but also
with regard to the clinical risk management and medical legal aspects related to the several profiles of professional responsibility