Intervention Leads to Reduction of C-Sections and Neonatal Morbidities

In New Orleans, researchers will report that Cesarean deliveries reviews and best practices implementation are effective to provide optimal care by an appropriate management of medical interventions.

This will lead to a significant reduction of cesarean deliveries and neonatal morbidity. The study is to be presented on Feb. 6 in an oral plenary session at 8 a.m. CST, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting™

Cesarean Deliveries More Than Double the WHO Norm in US
A study showed Tuesday, births by Cesarean section in the United States reached an all-time high in 2007, when some 1.4 million babies, or 32 percent of births, were by C-section.

The study, titled Quality of care, obstetrics risk management and mode of delivery in Quebec (QUARISMA): a cluster-randomized trial assessed the effect of a multifaceted intervention on the rate of cesarean deliveries, and on maternal and fetal health outcomes due to the promotion of professional onsite training and audit and feedback.

Researchers conducted a three-and-a-half year trial, during which they analyzed 105,351 deliveries in 32 randomly-chosen hospitals in Quebec. The hospitals were randomly assigned to either an intervention or a control group. The intervention was implemented over an 18 month period and consisted of an initial professional training on evidence-based clinical practices and internal audits and feedback on cesarean reviews and best practices implementation.

Results found that of the deliveries in hospitals of the intervention group, the rate of cesarean was significantly reduced, particularly for low-risk pregnancies. Furthermore, the rate of labor induction and assisted vaginal delivery were also significantly reduced by the intervention while the rate of the hormone oxytocin increased during labor in that group. The study's authors also observed a significant reduction in the risk of major and minor neonatal morbidity in the hospitals allocated to the intervention group, with the exclusion of all preterm births.

Sutures Cause Fewer Complications Than Staples With Cesarean Deliveries
There were less complications for women, after having a cesarean delivery, if sutures were used instead of staples to close the wound

"The reason we began the study was that it was important to address the rise of numbers of C-sections in Canada," said Nils Chaillet, Ph.D., one of the study's authors. "We had evidence about intervention being able to address the problem, so we had to assess the evidence. We found that best practices and complex intervention were successful in reducing C-sections and neonatal morbities."

"Our findings confirm that continuing professional education and structured internal audit can both reduce levels of obstetrical interventions and improve outcomes for mothers and babies. We feel that professional 'buy-in' is a key element in the success of the program," added William Fraser, M.D., another one of the researchers.

Maternity Program Results in Fewer Cesarean Sections, Shorter Hospital Stays for Mothers
Canadian Medical Association Journal says a collaborative maternity care program resulted in few cesarean deliveries, shorter hospital stays and higher breast-feeding rates for mothers.

Source-Eurekalert

Ways to Reduce First Cesarean Identified by Maternal-Fetal Medicine Professionals
A collaboration of specialists providing obstetrical care in helping to identify opportunities to reduce unnecessary first cesarean deliveries is highlighted in a recent article.