Analysis of caesarean section rates over time in a single Swiss centre using a ten-group classification system.

Müller, Andrea Martin; Kolly, Laura; Baumann, Marc; Imboden, Sara; Surbek, Daniel (2014). Analysis of caesarean section rates over time in a single Swiss centre using a ten-group classification system. Swiss medical weekly, 144(w13921), w13921. EMH Schweizerischer Ärzteverlag 10.4414/smw.2014.13921

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OBJECTIVE Caesarean section (CS) rates have risen over the past two decades. The aim of this observational study was to identify time-dependent variations in CS and vaginal delivery rates over a period of 11 years. METHOD All deliveries (13,701 deliveries during the period 1999-2009) at the University Women's Hospital Bern were analysed using an internationally standardised and approved ten-group classification system. Caesarean sections on maternal request (CSMR) were evaluated separately. RESULTS We detected an overall CS rate of 36.63% and an increase in the CS rate over time (p <0.001). Low-risk profile groups were the two largest populations and displayed low CS rates, with significantly decreasing relative size over time. The relative size of groups with induced labour increased significantly, but this did not have an impact on the overall CS rate. Pregnancies complicated by breech position, multiple pregnancies and abnormal lies did not have an impact on overall CS rate. The biggest contributor to a high CS rate was preterm delivery and the existence of a uterine scar from a previous CS. CSMR was 1.45% and did not have an impact on the overall CS rate. CONCLUSION The observational study identified wide variations in caesarean section and vaginal delivery rates across the groups over time, and a shift towards high-risk populations was noted. The biggest contributors to high CS rates were identified; namely, previous uterine scar and preterm delivery. Interventions aiming to reduce CS rates are planned.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Müller, Andrea Martin; Baumann, Marc; Imboden, Sara and Surbek, Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Monika Zehr

Date Deposited:

17 May 2016 11:43

Last Modified:

26 Jun 2016 01:53

Publisher DOI:

10.4414/smw.2014.13921

PubMed ID:

24554332

BORIS DOI:

10.7892/boris.54084

URI:

https://boris.unibe.ch/id/eprint/54084

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