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在巴西私人诊所中使用罗布森的10组分类系统达到适当的剖腹产率

Andrea Silveira de Queiroz Campos¹, Daphne Rattner², Carmen Simone Grilo Diniz³

¹Faculdade de Saúde Pública, Universidade de São Paulo, Av. Doutor Arnaldo, 715, 2º andar, Cerqueira César, São Paulo, 01246904, SP, Brasil. asqcampos@usp.br.

BMC pregnancy and childbirth

|July 10, 2023

概括

多学科的护理和积极的专业人员显著降低了巴西的剖腹产率,达到15.1%,符合世卫组织的建议. 这种方法即使在高度医疗化的环境中也被证明是有效的.

科学领域:

产科和妇科产科和妇科
公共卫生公共卫生
基于证据的医学基于证据的医学.

背景情况:

全球剖腹产率的上升与增加的孕产妇和新生儿并发症有关.
巴西的高CS率 (2019年为57%),超过了世卫组织 (10-15%) 建议的最佳孕产妇和婴儿结果.
过度的CS率会对分娩经历和健康结果产生负面影响.

研究的目的:

评估多学科护理和强烈的阴道分娩动机是否可以减少巴西私人诊所的阴道分娩过度使用.
将巴西私人实践中的CS率与国际数据,特别是瑞典数据进行比较.
在高度医疗化的背景下评估基于证据的协议的有效性.

主要方法:

罗布森集团在巴西一家私人诊所进行了一项横截面研究,分析了罗布森集团在巴西一家私人诊所的CS率.
巴西数据与瑞典CS率和罗布森集团分布的比较.
利用世卫组织的C模型工具来计算预期的CS率.
合作护理模式,涉及助产士和产科医生,遵循基于证据的指导方针.

主要成果:

私人诊所的整体CS率为15.1%,低于世卫组织C模型预期的19.8%的CS率.
罗布森分析了第一,第二和第5组,其中第5组 (以前的CS) 是CS率的重要贡献者.
巴西的CS率 (15.1%) 与瑞典的比率 (17.9%) 相当,尽管罗布森集团的组成不同.

结论:

多学科的护理和积极的专业人员可以显著和安全地降低剖腹产率.
这种方法即使在医疗化率高和CS过度使用的环境中也是有效的,比如巴西.
基于证据的协议对于优化分娩结果和减少不必要的干预至关重要.

关键词:

剖腹产的价格剖腹产的价格医疗保健模型医疗保健模型人性化分娩是一种人性化分娩.以患者为中心的护理,以证据为基础的实践.罗布森的分类. 罗布森分类.补充卫生保健补充健康

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