干旱区生态环境知识资源中心(Arid): Falling caesarean section rate and improving intra-partum outcomes: a prospective cohort study

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DOI	10.1080/14767058.2018.1439006
	Falling caesarean section rate and improving intra-partum outcomes: a prospective cohort study
	Amin, Pina 1; Zaher, Summia 1; Penketh, Richard 1; Cherian, Sobha 2; Collis, Rachel E.3; Sanders, Julia 4; Bhal, Kiron 5
通讯作者	Amin, Pina
来源期刊	JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
ISSN	1476-7058
EISSN	1476-4954
出版年	2019
卷号	32 期号:15 页码:2475-2480
英文摘要	Objective: To evaluate caesarean section (CS) rates and moderate to severe hypoxaemic ischaemic encephalopathy (HIE) rates with other core intra-partum outcomes following reconfiguration of maternity services in Cardiff, South Wales, UK. Design: Cohort study of births from 2006 to 2015. Settings: A University tertiary referral centre for foetal and maternal medicine with 6000 births/year, University Hospital of Wales, United Kingdom. Method: Data relating to births from 1 January 2006 to 31 December 2015 were extracted from the computerized maternity database on a yearly basis. Case notes of all mothers and babies for the same duration were hand searched for documentation of HIE. HIE data was also collected prospectively by neonatologist (SC) and obstetrician (PA). Main outcome measures: Incidence of caesarean section births, babies with moderate to severe HIE, instrumental vaginal births, obstetric anal sphincter injuries (OASIS) associated with instrumental delivery, and major post-partum haemorrhage (MPPH) of 2500 mL or more. Results: During this 10-year period, a downward trend in emergency CS rate was seen from 15.6% in 2006 to 10.5% in 2015, reducing total CS rate from 25.5% in 2006 to 21.2% in 2015. A downward trend in the incidence of moderate and severe HIE was seen over the same period. There was an increase in operative vaginal births (OVB) from 12.8% to 15%. The rate of spontaneous vaginal births (SVB) remained stable. The incidence of OASIS remained constant and MPPH rate has fallen. Conclusions: Following amalgamation of two medium sized obstetric units and the opening of a Midwifery Led Unit (MLU), core intrapartum outcomes have improved. Contributing factors are the introduction of regular multidisciplinary training with enhanced team working, compulsory education for obstetricians and midwives on cardiotocograph (CTG) interpretation, increased consultant presence on delivery suite, robust risk management systems and broad multidisciplinary agreement on clinical guidelines promoting vaginal birth.
英文关键词	Caesarean section instrumental vaginal delivery hypoxaemic ischaemic encephalopathy obstetric anal sphincter injuries major postpartum haemorrhage
类型	Article
语种	英语
国家	Wales
开放获取类型	Green Accepted
收录类别	SCI-E
WOS记录号	WOS:000466587700006
WOS关键词	INSTRUMENTAL DELIVERY ; CEREBRAL-PALSY ; 2ND-STAGE ; FORCEPS ; TRENDS ; LABOR
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/217231
作者单位	1.Univ Hosp Wales, Child Hlth & Womens Hlth Clin Board, Dept Obstet & Gynaecol, Cardiff, S Glam, Wales; 2.Univ Hosp Wales, Child Hlth & Womens Hlth Clin Board, Dept Child Hlth, Cardiff, S Glam, Wales; 3.Univ Hosp Wales, Anaesthet Clin Board, Dept Obstet Anaesthesia, Cardiff, S Glam, Wales; 4.Univ Hosp Wales, Midwifery Led Unit, Cardiff, S Glam, Wales; 5.Univ Hosp Wales, Dept Urogynaecl, Cardiff, S Glam, Wales
推荐引用方式 GB/T 7714	Amin, Pina,Zaher, Summia,Penketh, Richard,et al. Falling caesarean section rate and improving intra-partum outcomes: a prospective cohort study[J],2019,32(15):2475-2480.
APA	Amin, Pina.,Zaher, Summia.,Penketh, Richard.,Cherian, Sobha.,Collis, Rachel E..,...&Bhal, Kiron.(2019).Falling caesarean section rate and improving intra-partum outcomes: a prospective cohort study.JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE,32(15),2475-2480.
MLA	Amin, Pina,et al."Falling caesarean section rate and improving intra-partum outcomes: a prospective cohort study".JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE 32.15(2019):2475-2480.