Häger Renate, Øian Pål, Nilsen Stein Tore, Holm Hans Asbjørn, Berg Anne Birgitte F
Kvinneklinikken, Rikshospitalet, 0027 Oslo.
Tidsskr Nor Laegeforen. 2006 Jan 12;126(2):173-5.
The "breakthrough series" on caesarean section was organised in Norway in 1998/99 in response to professional concerns about rising caesarean section rates and the public debate about the topic. The aim was to gain more information and to reduce the inter-hospital variation of caesarean section rates.
Detailed information about 3000 caesarean sections (70% of all caesarean sections in Norway during the study period of 7 months) was collected. Twenty-four departments participated and were involved in a quality-improvement process.
In 1998 the caesarean section rate among the participating departments was 13.5% (inter-hospital variation 8.6% to 20.4%). In 2002 the rate was 15.7% (inter-hospital variation 11.0%-24.5%). The most frequent indications were fetal stress, prolonged labour, previous caesarean section, breech presentation and maternal request. Of the women with a previous caesarean section, 45.5% had a new caesarean section in their next pregnancy. Complications occurred in 21% of all procedures; risk factors were general anaesthesia, low gestational age, fetal macrosomia and degree of cervical dilation.
The project highlighted quality improvement work and interdisciplinary working processes and led to more knowledge about caesarean section. The inter-hospital variation was unchanged four years after the project.
1998/99年，挪威针对专业人士对剖宫产率上升的担忧以及公众对该话题的讨论，组织了“剖宫产突破系列”活动。目的是获取更多信息并减少各医院之间剖宫产率的差异。
收集了3000例剖宫产的详细信息（占研究期间挪威所有剖宫产的70%，为期7个月）。24个科室参与其中并参与了质量改进过程。
1998年，参与科室的剖宫产率为13.5%（医院间差异为8.6%至20.4%）。2002年，该比率为15.7%（医院间差异为11.0% - 24.5%）。最常见的指征是胎儿窘迫、产程延长、既往剖宫产史、臀位和产妇要求。有既往剖宫产史的女性中，45.5%在下一次妊娠时进行了再次剖宫产。所有手术中有21%发生了并发症；危险因素包括全身麻醉、孕周小、胎儿巨大和宫颈扩张程度。
该项目突出了质量改进工作和跨学科工作流程，并带来了更多关于剖宫产的知识。项目开展四年后，医院间差异没有变化。
