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Lowered national cesarean section rates after a concerted action

2015Journal article Restricted access
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dc.contributor.authorAyres-De-Campos, Diogo
dc.contributor.authorCruz, Joana
dc.contributor.authorMedeiros-Borges, Cláudia
dc.contributor.authorCosta-Santos, Cristina
dc.contributor.authorVicente, Lisa
dc.date.accessioned2015-10-14T14:47:26Z
dc.date.available2015-10-14T14:47:26Z
dc.date.issued2015
dc.description.abstractTo evaluate national cesarean section (CS) rates and other obstetric indicators after a concerted action to reduce CS rates was undertaken in Portugal from 2010 onwards. This action was based on the transmission of information and training of healthcare professionals, together with the inclusion of CS rates as a criterion for hospital funding. Retrospective observational population-based study. SETTING: Portugal. POPULATION: Births occurring in Portugal between 2000 and 2014. METHODS: Governmental sources were used to obtain data on national CS, perinatal and maternal mortality rates. Rates of instrumental vaginal delivery, vaginal birth after cesarean (VBAC), hypoxia-related complications and perineal lacerations were retrieved for state-owned hospitals. MAIN OUTCOME MEASURES: CS, perinatal and maternal mortality, instrumental vaginal delivery, VBAC, hypoxia-related complications and perineal lacerations. RESULTS: After a continuous rise between 2000 and 2009, national CS rates declined significantly over the following 5 years (36.6% vs. 33.1%, time trend p ≤ 0.001). Perinatal mortality maintained a downward trend during this period, while maternal mortality remained unchanged. Rates of instrumental vaginal delivery, VBAC and perineal lacerations increased, while the incidence of hypoxia-related complications decreased. CONCLUSIONS: A concerted action based on the transmission of information and training of healthcare professionals, together with the inclusion of CS rates as a criterion for hospital funding, was followed by a significant reduction in national CS rates, as well as an improvement in most related obstetric indicators. There may be an association between the reported intervention and the observed changes.pt_PT
dc.description.sponsorshipThe initial stages of the described concerted action were funded by the North Healthcare Regional Administration.
dc.identifier.doiDOI: 10.1111/aogs.12582
dc.identifier.urihttp://hdl.handle.net/10400.26/9924
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherNordic Federation of Societies of Obstetrics and Gynecologypt_PT
dc.relation.publisherversionhttp://onlinelibrary.wiley.com/doi/10.1111/aogs.12582/abstractpt_PT
dc.subjectSaúde Sexual e Reprodutivapt_PT
dc.subjectCesareanapt_PT
dc.subjectPortugalpt_PT
dc.titleLowered national cesarean section rates after a concerted actionpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage398pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage391pt_PT
oaire.citation.titleActa Obstetricia et Gynecologica Scandinavicapt_PT
oaire.citation.volume94pt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT

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