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[Cesarean section and perinatal mortality].

G Schulze1, H Radzuweit, K H Peschke

  • 1Frauenklinik, Bezirkskrankenhauses Cottbus.

Zentralblatt Fur Gynakologie
|January 1, 1990
PubMed
Summary

This study analyzed 727 caesarean sections (C.S.) finding no direct link between C.S. rates and perinatal mortality. However, higher C.S. rates in specialized centers correlated with reduced newborn mortality, suggesting a new index for comparison.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Medical Informatics

Background:

  • Caesarean section (C.S.) rates vary significantly between obstetrical centers and general hospitals.
  • The relationship between C.S. rates and perinatal mortality requires nuanced analysis considering various obstetric factors.

Purpose of the Study:

  • To analyze caesarean section (C.S.) rates and their correlation with perinatal mortality across different healthcare settings.
  • To investigate the impact of neonatological indications on C.S. rates.
  • To propose a novel metric, the caesarean section-index of perinatal mortality, for better comparative analysis.

Main Methods:

  • Multicentric prospective study involving 727 caesarean section cases from 13 obstetrics and gynecology departments.
  • Computer-aided analysis of C.S. data collected in 1987.
  • Comparative analysis of C.S. rates and perinatal mortality between specialized centers and general district hospitals.

Main Results:

  • C.S. rates ranged from 6.5% to 13.4% in obstetrical centers and 2.6% to 6.7% in general hospitals.
  • No direct correlation was found between C.S. rate and perinatal mortality within a single department.
  • Higher C.S. rates in specialized centers, driven by neonatological indications, were associated with a significant reduction in perinatal mortality for C.S. deliveries.

Conclusions:

  • Perinatal mortality and C.S. rates are comparable only when considering all deliveries and the prevalence of high-risk cases.
  • The proposed caesarean section-index of perinatal mortality (ratio of perinatal mortality in C.S. newborns to total perinatal mortality) can offer a more accurate comparative measure.
  • Neonatological indications play a crucial role in elevated C.S. rates in specialized centers, potentially improving neonatal outcomes.

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