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首页> 外文期刊>International Journal of Reproduction, Contraception, Obstetrics and Gynecology >Interventions to reduce caesarean section rates at government medical college and hospital Aurangabad, India
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Interventions to reduce caesarean section rates at government medical college and hospital Aurangabad, India

机译：减少政府医学院和医院Aurangabad，印度的剖腹产的干预措施

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Background: Caesarean sections are effective in saving maternal and infant lives, but only when they are performed for medically indicated reasons, The Objective of this study was to reduce caesarean Section rate at GMCH, Aurangabad and to improve overall birthing experience with respectful maternity care. Methods: The caesarean sections done at GMCH Aurangabad were audited using Robson`s Ten Group classification system to identify the major contributors to the overall CS rate. The following clinical and non-clinical interventions were applied dynamically to control the caesarean section rates. Clinical Interventions were changes in protocols regarding induction of labour, Intermittent auscultation as opposed to continuous electronic foetal monitoring in low risk cases, use of a partogram, encouragement of different birthing positions, promoting TOLAC to reduce the secondary CS rate. Nonclinical interventions include encouragement of DOULA (birth companion), ante-natal counselling of the expectant mothers, training of healthcare staff for respectful maternity care and use of evidence based clinical practice guidelines with mandatory second opinion for every non recurrent indication of CS. Auditing of caesarean section using Robson classification. Results: In this study there has been steady decline in LSCS rates from 33% to 26.9%. On analysis with Robson classification, group 5 (previous LSCS) made largest contribution of 36.9% followed by Group 1, 2, 10 each contributed 18.01%,13.2% and 11.2% respectively. Group 6 to 10 account for 23%. Various birthing positions lowered use of oxytocics from 33 % to 19% as well lowered episiotomy rates with greater success in vaginal delivery. Conclusions: Modification of induction protocols have reduced the primary LSCS rates and successful VBAC using FLAMM score was helpful in reducing the repeat caesarean Sections. Various birthing positions, DOULA gave greater success in vaginal delivery. LSCS rates in mothers with breech, multiple or oblique/transverse lies were largely unmodifiable. Limiting the CS rate in low-risk pregnancies by individualizing every labour and not to set a time limit as long as mother and baby are closely monitored.
机译：背景：剖腹产在储蓄母婴生命中是有效的，但只有当他们因医学上表现出原因而进行时，本研究的目的是降低GMCH，Aurangabad的剖宫产率，并提高尊重的产妇护理的整体分娩体验。方法：在GMCH Aurangabad完成的凯撒部分使用Robson`s十组分类系统审核，以确定整个CS率的主要贡献者。以下临床和非临床干预措施被动态施用以控制剖腹产率。临床干预措施是关于劳动的诱导，间歇性听诊的方案变化，而是在低风险案件中的连续电子胎儿监测，使用分组，鼓励不同分娩位置，促进托拉援助降低二次CS率。非临床干预包括鼓励牛阵（出生伴侣），对预期母亲的对手咨询，医疗保健人员培训，以尊重的产妇护理和使用基于证据的临床实践指南，为每个不经常性指示的CS强制第二意见。使用罗布森分类审计剖腹产。结果：在本研究中，LSC的稳定下降从33％到26.9％。在罗布森分类分析上，第5组（以前的LSC）为1,2,10级的最大贡献分别为1,2,10级，分别贡献了18.01％，13.2％和11.2％。第6至10组占23％。各种分娩位置降低了33％至19％的催化剂，因为降低了阴道递送的更大成功。结论：诱导方案的修饰降低了主要LSC率和使用FLAMM得分的成功VBAC有助于减少重复剖腹产。各种分娩位置，Doula在阴道递送方面取得了更大的成功。母亲的LSC率是臀部，多重或斜/横向谎言的主要原因是不可替代的。只要母亲和婴儿密切监测，通过每个劳动来限制低风险怀孕的CS率，而不是设定时间限制。

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