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Primary cesarean delivery rate: Potential impact of a checklist
M Toumi1, E Lesieur1, J-B Haumonte2
1University Hospital centers Nord and Conception in Marseille, France; Department of Gynaecology and Obstetrics, Gynepole, AP-HM, Assistance Publique-Hôpitaux de Marseille, AMU, Aix-Marseille Université, France.
Background:
Cesarean section is the most common surgical procedure performed in developed countries. Its incidence is increasing to a worrisome extent. The 2003 French National Perinatal Survey showed that the inflation in the overall cesarean rate was mainly due to an increase in the first cesarean delivery rate.
Objective:
To evaluate a new tool: a checklist that intent to decrease the first cesarean delivery rate.
Study Design:
Retrospective, observational, multi-center study. A new tool, a "First cesarean delivery" checklist was built according American and French guidelines. Women with full-term of pregnancy, nulliparous or multiparous with a first caesarean delivery including arrest of labor, breech presentation or suspected fetal macrosomia were included. The checklist was applied. Potentially preventable cesareans were analyzed.
Results:
Among 571 first cesarean section, 178 were eligible to check list application. 147 charts were analyzed in the study. 11.9% of first cesarean deliveries performed were potentially avoidable after applying the checklist. This represented 6.6% of all cesareans.
Conclusion:
The checklist based on the recall of good practices could be an interesting tool to decrease the first cesarean rate.
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