Paleari L, Gibbons L, Chacón S, Ramil V, Belizán JM

Language: Spanish
References: 10
Page: 263-269
PDF size: 202.76 Kb.

ABSTRACT

Background: In recent years, rising rates of caesarean section are of concern in the medical community in many countries, especially in Latin America
Objective: Determine if there is a difference in the rate of Caesarean sections in a restricted-access hospital (HC) and an open-access hospital (HA) using the Robson classification to explain potential differences.
Material and method: A prospective cohort study was conducted. This in volved all patients that attended the obstetrics sector in the two hospitals in Buenos Aires where they gave birth between 1 June 2009 and 25,h January 2010. The open-access hospital is open to doctors with varying professional training and differing clinical practice. The restricted-access hospital, on the other hand, can only be attended by specified doctors with certain professional training; their medical) conduct is based on service standards and clinical practice.
Results: Over the study period 762 patients who fulfilled the study criteria were included from the open-access hospital and 768 from the restrictedaccess hospital. The global rate of caesarean sections in the HA was 53.5%, and 48.7% in the HC, RR 1.09 (Cl 0.99-1.21) a difference that was not statistically significant (p=0.058). The onset of spontaneous labour in the HA was significantly more than in the HC (74.9% vs. 41.8%) RR 2.66 (CU.98-3.57). The induced labour was significantly lower in HA (9,7% vs. 28,3%); RR 0.34 (Cl 0.27-0.44). Elective caesarean sections were significantly lower in the HA (15.3% vs. 29.9%) RR 0.51 (Cl 0.42-0.62).
Conclusion: This study reveals a similar rate of caesarean sections in two private hospitals with different systems of care. However, it observed that the HA has a greater tendency to operate on patients at the onset of spontaneous labour and the HC has a greater number of induced labour and elective caesarean section.

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