ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne1993
Cesarean section: analysis of the experience before and after the National Consensus Conference on Aspects of Cesarean Birth.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 1993. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 28 citations in OpenAlex.
- After a Cesarean…What's a Birth Professional to Do?The Journal of perinatal education · 2010Article
- Interspecialty differences in the obstetric care of low-risk women.American journal of public health · 1997Article
- Reducing the frequency of episiotomies through a continuous quality improvement program.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 1995Article
- Cesarean section rates in Italy.American journal of public health · 1994Article
- Surgery for Severe Ulcerative Colitis during Pregnancy: Report of Two Cases.Case reports in gastroenterologyArticle
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the effect of recommendations to reduce the cesarean section rate issued by the National Consensus Conference on Aspects of Cesarean Birth in 1986 on obstetric practices and to identify current patient factors that predict cesarean section.
designDescriptive retrospective cross-sectional study.
settingA tertiary care perinatal referral centre and a general teaching hospital with a level 2 nursery in Hamilton, Ont. PATIENTS: All patients who gave birth at the two hospitals in 1982 (4121 women) and 1990 (4431).
main outcome measuresCesarean section rates and indications and predictors of cesarean section.
resultsAlthough a trial of vaginal delivery after cesarean section was offered 93% more often in 1990 than in 1982 (p = 0.0002), the rate of vaginal delivery increased only 2.6%, for a reduction of 8.7% in the total cesarean section rate and of 15% in the repeat cesarean section rate. The incidence rate and treatment of dystocia did not change. The rate of cesarean section for breech presentation remained unchanged, and fetal distress was rarely confirmed with pH measurement in scalp blood before cesarean section. The most important predictors of cesarean section in 1990 were previous cesarean section and labour induction. For the nulliparous women and the multiparous women with no previous cesarean section labour induction was the most important predictor.
conclusionsThe rate at which patients with previous cesarean section are offered a trial of vaginal delivery has increased significantly since 1982; however, the total and repeat cesarean section rates have not decreased proportionally. Induction of labour is currently the most important correctable predictor of cesarean section. The active management of dystocia, efforts to increase the rate of vaginal breech delivery and appropriate methods to diagnose fetal distress need to be improved; such improvements should reduce the cesarean section rate further.
Indexed as
Identifiers
8462053PMC1491710W1880224545What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.