Saha Sudarsan, Saha Soma, Das Rupkamal, Chakraborty Mayoukh, Bala Himadri Sekhar, Naskar Priyankar
Department Obstetrics and Gynaecology, Calcutta National Medical College and Hospital, Kolkata, 700 014 India.
J Obstet Gynaecol India. 2012 Aug;62(4):391-7. doi: 10.1007/s13224-012-0288-8. Epub 2012 Oct 16.
To check the progressive increasing trend of caesarean delivery in a tertiary facility care centre.
The purpose of this study is to implement a paradigm shift in caesarean delivery by introducing a new classification system and a check list based management protocol.
The study was conducted from 1st January, 2007 to 31st December, 2008 at CNMC G&O Department. All deliveries in the year 2007 were compared retrospectively and all deliveries in the year 2008 under prospective study with implementation of a new strategic protocol. Comparative audit and analysis of deliveries in retrospective and prospective year reveals significant changes in the caesarean delivery rate.
In retrospective group all women in labour were allowed for spontaneous delivery and in prospective group all women were subjected to intervention protocol and caesarean delivery done in both the groups in need for risk of fetal and maternal salvage. Incidence of caesarean delivery (CD) in retrospective group was 29 % while in the prospective group it was 18.4 %. Marked decrease in CD was observed for augmentation, induction and trial of labour (TOL) for delivery in prospective group. The result was compared with Robson's studies following similar type of classification system.
Marked improvement was noticed in this new paradigm and more multicentric trial is needed to check the increasing trend of CD.
在一家三级医疗机构护理中心检查剖宫产率的逐步上升趋势。
本研究的目的是通过引入一种新的分类系统和基于检查表的管理方案，实现剖宫产模式的转变。
该研究于2007年1月1日至2008年12月31日在CNMC妇产科进行。对2007年的所有分娩进行回顾性比较，并对2008年实施新战略方案的所有分娩进行前瞻性研究。对回顾性和前瞻性年份的分娩进行比较审计和分析，发现剖宫产率有显著变化。
回顾性组中所有临产妇女均允许自然分娩，前瞻性组中所有妇女均接受干预方案，两组中为挽救胎儿和产妇生命而需要进行剖宫产的情况。回顾性组的剖宫产发生率为29%，而前瞻性组为18.4%。前瞻性组中，用于分娩的引产、催产和试产的剖宫产率明显下降。将结果与采用类似分类系统的罗布森研究进行了比较。
在这一新模式中观察到了显著改善，需要更多的多中心试验来检查剖宫产率的上升趋势。
