ArticleHealth science reports2025
Re-Striking the Indications in the Improvement of Avoidable Caesarian Section: A Cluster Randomized Control Trial.
Article in Health science reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
Background and Aims: Cesarean section (CS) rates are on the rise globally, creating serious public health concern with their increased risk of morbidity and mortality for low-risk pregnancies. The aim of this study is to identify whether re-striking the indications of CS can reduce the rate of unnecessary procedures at a system level, whilst preserving maternal and fetal outcomes. Methods: This cluster randomized controlled trial recruited 277 Bangladeshi antenatal patients between 2020 and 2021, evaluating them in two groups: 138 individuals in the intervention group and 139 in the control group. A CS was recommended for any deviation from normal labor progression, with clinical experts providing second opinions and ongoing patient care in the intervention group. The incidence risk ratio (IRR) was calculated utilizing bias-corrected multivariable Poisson regression models and adjusting for cluster variation and plausible confounders. Results: We utilized cluster-adjusted samples with identical baseline characteristics among study groups. Re-striking the indication reduces the likelihood of CS (IRR = 0.87, 95% CI = 0.82-0.93; Conclusion: Re-striking the primary indications for cesarean sections is crucial for reducing avoidable deliveries; that is why it should be integrated into hospital policy to benefit patients and the healthcare system.
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