Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study

Abstract Objective To evaluate the impact on cesarean section (CS) rate with of a program of multiple non-clinical interventions targeted at health-care professional within a hospital maternity ward. Materials and methods Retrospective quasi-experimental pre-post intervention study with an historica...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	A. Fruscalzo, K. Reinecke, A. P. Londero, M. Gantert
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Intervention Cesarean section reduction Vaginal delivery Operative delivery Delivery complications Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/27cb291957754751a6f9ff211fcd4960
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:27cb291957754751a6f9ff211fcd4960
record_format	dspace
spelling	oai:doaj.org-article:27cb291957754751a6f9ff211fcd49602021-11-21T12:32:53ZComposite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study10.1186/s12884-021-04245-y1471-2393https://doaj.org/article/27cb291957754751a6f9ff211fcd49602021-11-01T00:00:00Zhttps://doi.org/10.1186/s12884-021-04245-yhttps://doaj.org/toc/1471-2393Abstract Objective To evaluate the impact on cesarean section (CS) rate with of a program of multiple non-clinical interventions targeted at health-care professional within a hospital maternity ward. Materials and methods Retrospective quasi-experimental pre-post intervention study with an historical control group conducted in a second-level teaching hospital. All women who gave birth in the period 2014 to 2018 were included. A series of multiple non-clinical interventions including a dedicated team of obstetricians for delivery room and antenatal counseling, monthly internal audits and physician education by local opinion leader were prospectively introduced from September 2016. The primary outcome of the study was the CS rate. The incidences of operative vaginal delivery, 3rd−/4th-degree perineal tears and further maternal and neonatal complications were considered as secondary outcomes. Results The CS rate dropped from 33.05 to 26.06% after starting the interventions (p < 0.01); in particular, the cumulative rate of CS performed during labor decreased significantly from 19.46 to 14.11% (p < 0.01). CS reduction was still statistically significant after multivariate correction (OR = 0.66, CI.95 = 0.57–0.76, p < 0.01). Results further showed an increased prevalence of 3rd-degree perineal tears (0.97% versus 2.24%, p < 0.01), present also after correcting for possible confounding factors (OR = 2.36, CI.95 = 1.48–3.76, p < 0.01). No differences were found in the rate of vaginal-operative births and further maternal complications, while the composite neonatal outcome was found to be improved (OR = 0.73, CI.95 = 0.57–0.93, p = 0.010). Conclusions The introduction of multiple non-clinical interventions can significantly reduce the CS rate. However, beside an improvement in neonatal composite outcome, a potential increase in high-degree perineal tears should be taken in account.A. FruscalzoK. ReineckeA. P. LonderoM. GantertBMCarticleInterventionCesarean section reductionVaginal deliveryOperative deliveryDelivery complicationsGynecology and obstetricsRG1-991ENBMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Intervention Cesarean section reduction Vaginal delivery Operative delivery Delivery complications Gynecology and obstetrics RG1-991
spellingShingle	Intervention Cesarean section reduction Vaginal delivery Operative delivery Delivery complications Gynecology and obstetrics RG1-991 A. Fruscalzo K. Reinecke A. P. Londero M. Gantert Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study
description	Abstract Objective To evaluate the impact on cesarean section (CS) rate with of a program of multiple non-clinical interventions targeted at health-care professional within a hospital maternity ward. Materials and methods Retrospective quasi-experimental pre-post intervention study with an historical control group conducted in a second-level teaching hospital. All women who gave birth in the period 2014 to 2018 were included. A series of multiple non-clinical interventions including a dedicated team of obstetricians for delivery room and antenatal counseling, monthly internal audits and physician education by local opinion leader were prospectively introduced from September 2016. The primary outcome of the study was the CS rate. The incidences of operative vaginal delivery, 3rd−/4th-degree perineal tears and further maternal and neonatal complications were considered as secondary outcomes. Results The CS rate dropped from 33.05 to 26.06% after starting the interventions (p < 0.01); in particular, the cumulative rate of CS performed during labor decreased significantly from 19.46 to 14.11% (p < 0.01). CS reduction was still statistically significant after multivariate correction (OR = 0.66, CI.95 = 0.57–0.76, p < 0.01). Results further showed an increased prevalence of 3rd-degree perineal tears (0.97% versus 2.24%, p < 0.01), present also after correcting for possible confounding factors (OR = 2.36, CI.95 = 1.48–3.76, p < 0.01). No differences were found in the rate of vaginal-operative births and further maternal complications, while the composite neonatal outcome was found to be improved (OR = 0.73, CI.95 = 0.57–0.93, p = 0.010). Conclusions The introduction of multiple non-clinical interventions can significantly reduce the CS rate. However, beside an improvement in neonatal composite outcome, a potential increase in high-degree perineal tears should be taken in account.
format	article
author	A. Fruscalzo K. Reinecke A. P. Londero M. Gantert
author_facet	A. Fruscalzo K. Reinecke A. P. Londero M. Gantert
author_sort	A. Fruscalzo
title	Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study
title_short	Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study
title_full	Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study
title_fullStr	Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study
title_full_unstemmed	Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study
title_sort	composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/27cb291957754751a6f9ff211fcd4960
work_keys_str_mv	AT afruscalzo compositenonclinicalinterventionsforasafecesareansectionratereductionresultsofaprepostinterventionalstudy AT kreinecke compositenonclinicalinterventionsforasafecesareansectionratereductionresultsofaprepostinterventionalstudy AT aplondero compositenonclinicalinterventionsforasafecesareansectionratereductionresultsofaprepostinterventionalstudy AT mgantert compositenonclinicalinterventionsforasafecesareansectionratereductionresultsofaprepostinterventionalstudy
_version_	1718418932211122176

Composite non-clinical interventions for a safe cesarean section rate reduction: results of a pre-post interventional study

Ejemplares similares