Lithuanian University of Health Sciences, Eiveniu str. 2, 50167, Kaunas, Lithuania.
Victoria Hospital, Kirkcaldy, Fife, Scotland, KY2 5AH, UK.
BMC Pregnancy Childbirth. 2020 Mar 12;20(1):152. doi: 10.1186/s12884-020-2806-5.
To evaluate the role of the quality improvement course (QIC) to reduce the caesarean section (CS) rate among nulliparas (Robson groups 1 and 2) and to find out which group of women have reduced the CS rate following attendance at the course.
The QIC was organized in 2015. For the evaluation of the CS rate after the OIC, deliveries from the selected hospitals in 2014 and 2016 were compared using MS EXCEL and SPSS 23.0.
Nulliparas accounted for 44.6% (3585/8046) and 42.9% (3628/8460) of all the deliveries in 2014 and 2016 years, respectively. The CS rate among nulliparas decreased from 19.0% (665/3502) in 2014 to 16.8% (593/3526) in 2016 (p = 0.018). The greatest decrease in absolute contribution to the overall CS rate was recorded in group 1 (p = 0.08). Perinatal mortality was 3.1 in 2014 and 3.9 in 2016 per 1000 deliveries (p = 0.569).
The QIC has helped to reduce the CS rate among nulliparas without a negative influence on perinatal mortality. The greatest decrease in the overall CS rate was recorded among nulliparous women who were treated with oxytocin and managed to reach a full cervical dilatation.
评估质量改进课程（QIC）在降低初产妇（罗伯逊分组 1 和 2）剖宫产率中的作用，并找出参加该课程后哪些组的妇女降低了剖宫产率。
QIC 于 2015 年组织。为了评估 OIC 后剖宫产率，使用 MS EXCEL 和 SPSS 23.0 比较了 2014 年和 2016 年选定医院的分娩情况。
初产妇占 2014 年和 2016 年所有分娩的 44.6%（3585/8046）和 42.9%（3628/8460）。初产妇剖宫产率从 2014 年的 19.0%（665/3502）降至 2016 年的 16.8%（593/3526）（p=0.018）。对总体剖宫产率绝对贡献的最大降幅发生在第 1 组（p=0.08）。2014 年和 2016 年每千例分娩的围产儿死亡率分别为 3.1 和 3.9（p=0.569）。
QIC 有助于降低初产妇的剖宫产率，而不会对围产儿死亡率产生负面影响。总体剖宫产率的最大降幅发生在接受催产素治疗并成功达到完全宫颈扩张的初产妇中。
