[Introducing a daily obstetric audit: A solution to reduce the cesarean section rate?]

Area of Science:

• Obstetrics and Gynecology
• Healthcare Quality Improvement
• Surgical Outcomes Research

Background:

• High rates of caesarean sections present challenges in obstetric care.
• Accurate indication assessment is crucial for optimizing delivery methods.
• Medical audits can drive improvements in clinical practice.

Purpose of the Study:

• To assess the effect of a medical audit on caesarean section indications.
• To evaluate the impact of this audit on the overall caesarean section rate.
• To determine changes in emergency caesarean and instrumental delivery rates.

Main Methods:

• A comparative observational study was conducted over two quadrimester periods.
• The first period lacked a caesarean section audit; the second incorporated a daily audit.
• Caesarean and instrumental delivery rates were compared between the periods.

Main Results:

• The caesarean section rate decreased from 26.2% to 23.8% (P=0.014).
• Emergency caesarean rates fell from 19.6% to 16.7% (P=0.02).
• Instrumental delivery rates increased from 14.4% to 17.2% (P=0.0004), with no adverse maternal or infant outcomes.

Conclusions:

• A daily obstetric audit of caesarean indications effectively reduces emergency caesarean rates.
• The audit promotes more active management throughout labor.
• This quality improvement strategy enhances obstetric care efficiency.