Related Experiment Video
Updated: Jul 4, 2026
08:49
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Impact of a Structured Caesarean Reduction Strategy on Perinatal Outcomes: A Retrospective Ecological Time-Trend
Stefania Fieni1, Giovanni Morganelli1, Gabriella Maria Celora1
1Department of Obstetrics and Gynecology, Parma University Hospital, Parma, Italy.
Summary
A structured strategy significantly reduced Cesarean section (CS) rates after 2016 without negatively impacting maternal or neonatal health. This approach improved vaginal birth after Cesarean (VBAC) rates, demonstrating effective obstetric care improvements.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health Interventions
Background:
- Cesarean section (CS) rates have risen globally, necessitating effective reduction strategies.
- High-complexity obstetric centers require tailored approaches to manage delivery interventions.
- Evaluating long-term impacts of multidisciplinary interventions is crucial for sustainable practice changes.
Purpose of the Study:
- To assess the long-term effectiveness of a structured, multidisciplinary Cesarean section (CS) reduction strategy.
- To analyze the impact of the intervention on maternal and neonatal morbidity.
- To evaluate trends in vaginal birth after Cesarean (VBAC) and uterine rupture rates.
Main Methods:
- Retrospective ecological time-trend study of 28,577 deliveries (2014-2024) at a tertiary Italian center.
- Implementation of a multifaceted improvement program in 2014, including standardized protocols, staff training, and revised intrapartum care guidelines.
- Segmented regression analysis to assess temporal trends in CS rates and associated maternal/neonatal outcomes.
Main Results:
- A significant downward trend in CS rates was observed post-2016 (–1.64% per year, p < 0.001) following the intervention.
- Vaginal birth after Cesarean (VBAC) rates significantly increased over the study period.
- Maternal and neonatal outcomes remained stable, with no significant adverse effects, though postpartum hemorrhage showed a modest increase.
Conclusions:
- A structured, multifaceted strategy effectively reduced Cesarean section (CS) rates.
- The observed decline in CS rates was sustained and not linked to adverse maternal or neonatal outcomes.
- The intervention demonstrated a positive impact on obstetric care, including increased VBAC rates.
Related Concept Videos
01:28Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...