DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20183791

A clinical study of effect of standard labour protocols on rates of primary caesarean section at a tertiary care centre, Madurai, India

Shanthi C., Mahalakshmi N. K.

Abstract


Background: Caesarean section rates are on the rise all over the world. Primary caesarean section usually determines the future obstetric course of any woman and therefore should be avoided whenever possible. WHO recommended that caesarean rates should not be more than 15 %. In this view we started our study on how to reduce the rate of Primary caesarean section in Tertiary Care Centre, Madurai, India. The objective of the present study was to evaluate how the implementation of universally acceptable standards affects rates of primary caesarean section rates without compromising maternal and foetal safety

Methods: This a comparative study on the effect of standard labour protocols and guidelines devised after audit of cases from January 2017 to June 2017, on the rate of primary caesarean section rates, induction of labour, failed induction, maternal and fetal outcomes before and after the implementation of the guidelines.

Results: Primary caesarean section rates from 52.85% to 45.02% noted in the induced cases. There were no significant adverse maternal and perinatal outcomes.

Conclusions: Implementation of standard labour protocols can reduce primary caesarean section rate without compromising maternal or foetal safety.


Keywords


Audit, Implementation of labour, Protocols, Primary Caesarean section,

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References


Kazmi T, Sarva Saiseema V, Khan S. Analysis of Cesarean section rate-according to Robson’s 10-group classification. Oman Med J. 2012;27(5):415-7.

Tanaka K, Mahomed K. The ten-group robson classification: a single centre approach identifying strategies to optimise caesarean section rates. Obstetrics Gynecol Int. 2017;2017.

Yadav RG, Maitra N. Examining cesarean delivery rates using the Robson’s ten-group classification. J Obstet Gynecol India. 2016;66(1):1-6.

Caughey AB, Cahill AG, Guise JM, Rouse DJ, American College of Obstetricians and Gynecologists. Safe prevention of the primary cesarean delivery. American journal of obstetrics and gynecology. 2014;210(3):179-93.

Patar Jagannath,Malakar Himangshu,Pronamika konyak, Balsrich Marak, Ishaa Goel Primary caesarean section in primigravida : a clinical study Sch J App Med Sci. 2016:4(9B);3307-11.

Sanchez-Ramos L, Kaunitz AM, Peterson HB, Martinez-Schnell B, Thompson RJ. Reducing cesarean sections at a teaching hospital. American J Obstet Gynecol. 1990;163(3):1081-8.

Myers SA, Gleicher N. A successful program to lower cesarean-section rates. New Eng J Med. 1988;319(23):1511-6.

Socol ML, Garcia PM, Peaceman AM, Dooley SL. Reducing cesarean births at a primarily private university hospital. Am J Obstet Gynecol. 1993;168(6):1748-58.

Bickell NA, Zdeb MS, Applegate MS, Roohan PJ, Siu AL. Effect of external peer review on cesarean delivery rates: a statewide program. Obstet Gynecol. 1996;87(5):664-7.

Somprasit C, Tanprasertkul C, Kamudhamas A. Reducing caesarean delivery rates: an active management labour program. J Med Assoc Thai.2005;88(1):20-5.