Trends in operative delivery rates

Česká verzia

Authors: M. Větr
Authors place of work: Gynekologicko porodnická klinika FN a LF UP Olomouc, přednosta doc. MUDr. R. Pilka, Ph. D.
Published in the journal: Ceska Gynekol 2009; 74(5): 355-359

Summary

Objective:
The aim of this study was to identify trends in operative vaginal delivery rates and caesarean sections at Faculty Hospital in Olomouc and comparing with mean results of the Czech republic.

Design:
Retrospective epidemiological study.

Setting:
Gynaecology and Obstetrics Clinic Medical Faculty Palacky University and Faculty Hospital in Olomouc.

Methods:
Analysis of data drawn from obstetric medical records from 1. 1. 1993 to 31. 12. 2008 – rating the frequency, evolutionary trends and associated risk factors.

Results:
In this time period 26 679 children born, by caesarean section 5 916 (22,2%), ventouse 759 (2,8 % ) and forceps 526 ( 2,0%). The frequency of vaginal operations is higher than the average of the Czech Republic and from second half 90s of the 20th century no more increased. For caesarean section, however, is an upward trend (P for trend = 0.035, Cox - Stuart test). The increasing proportion of complex of 4 risk factors on the frequency of caesareans: 1 low birth weight below 2.5 kg (32.2%), 2 multiple pregnancy (18%), 3 caesareans in history (15.5%), 4 mothers over the age of 35 years (11.2%). Cumulative share of all four factors in the total number of abdominal delivery has reached a mean of 52.91% (95% CI 49,58-56,24), median = 53.75 (97.9% CI 48,64-57,32).

Conclusion:
Analysis of the development of operational termination of pregnancy confirms the significantly higher frequency of operational interventions in Olomouc compared to an average of the Czech Republic. Changes in risk profile of patients (often referred to the demographic factors) is not enough to explain the causes of the rising frequency of caesareans. The increase of invasive obstetrics undoubtedly contributes to changes in obstetric practice.

Key words:
forceps, ventouse extraction, caesarean section, trends, risk factors.

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