Alarming global rise in caesarean births, figures show

Wise, Jacqui

doi:10.1136/bmj.k4319

Cited by 36 publications

(32 citation statements)

References 4 publications

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“…In addition, we feel the rate of caesarean section in Brazilian maternity wards is extremely high (50.1%). This is consistent with the national scenario, as the C-section rates in Brazil are one of the highest worldwide 32. It also raises the possibility that some of the AEs would have been preventable if related to C-sections, simply because many of the C-sections are likely to be unnecessary.…”

Section: Discussionsupporting

confidence: 82%

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Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude

Sousa

Pimenta

Elorriaga³

et al. 2019

BMJ Open

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ObjectiveTo evaluate the quality of delivery care in maternity wards in Brazil and Mexico based on good practices (GP) and adverse events (AE), in order to identify priorities for improvement.DesignA multicentre cross-sectional study with data collection from medical records between 2015 and 2016 to compare indicators of maternal and neonatal GP and EA based on the Safe Childbirth Checklist and standardised obstetric quality indicators. Two Brazilian and five Mexican maternity wards participated in the study. Descriptive statistics and χ2 tests were performed to assess performance and significant differences between the hospitals investigated.SamplingWe analysed 720 births in Brazil and 2707 in Mexico, which were selected using a systematic random sampling of 30 medical records every fortnight for 12 2-week periods in Brazil and 18 2-week periods in Mexico. We included women and their newborns, excluding those with congenital malformations.ResultsThe Mexican hospitals showed greater adherence to GP (58.2%) and a lower incidence of AE (12.9%) than the participating institutions in Brazil (26.8% compliance with GP and 16.0% AE). In spite of these differences, the relative importance of particular quality problems and type of AE are similar in both countries. Tertiary hospitals, caring for women at higher risk, have significantly (p<0.001) higher rates of AE (27.2% in Brazil and 29.6% in Mexico) than institutions attending women at lower risk, where the frequency of AE ranges from 4.7% to 11.2%. Differences were significant (p<0.001) for most indicators of GP and AE.ConclusionData from outcome and process measures revealed similar types of failures in the quality of childbirth care in both countries and indicate the need of rationalising the use of antibiotics for the mother and episiotomy, encouraging greater adherence to partograph and to the use of magnesium sulfate for the treatment of severe preeclampsia/eclampsia.

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Section: Discussionsupporting

confidence: 82%

“…The growth of caesarean section internationally is evident 32–34. According to the latest data from 150 countries, the average global rate of caesarean section is 18.6% 34.…”

Section: Discussionmentioning

confidence: 99%

Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude

Sousa

Pimenta

Elorriaga³

et al. 2019

BMJ Open

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“…Similar caesarean rates in women with PE have been reported by other studies conducted in developing countries [23]. However, PE is not considered an absolute indication for caesarean delivery [13], and caesarean rates fluctuate greatly between and within countries [24]. The high rate found in the current study is probably not medically justified, and is not exclusively related to cases of PE.…”

Section: Excessive Rates Of Preeclampsia and Caesarean Delivery Highlsupporting

confidence: 84%

“…The high rate found in the current study is probably not medically justified, and is not exclusively related to cases of PE. Indeed, Brazil presents high rates of caesarean section in general [24]. In other developing countries, the incidence of caesarean delivery in cases of PE is 42.6% [20], which is far below the frequency observed here.…”

Section: Excessive Rates Of Preeclampsia and Caesarean Delivery Highlcontrasting

confidence: 65%

The WHO Safe Childbirth Checklist implementation: impact on the prescription of magnesium sulphate through a one-year longitudinal study

Gama

Medeiros

Saturno-Hernández

et al. 2020

BMC Pregnancy Childbirth

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Background: Preeclampsia is a relatively frequent condition during pregnancy and childbirth. The administration of magnesium sulphate as a prophylactic and treatment measure is an evidence-based practice for eclampsia; however, it is not consistently used, compromising the health of pregnant women. This study aimed to assess compliance with recommendations of the International Society for the Study of Hypertension in Pregnancy (ISSHP) for the use of MgSO 4 in pregnant women with preeclampsia, before and after the implementation of the World Health Organization Safe Childbirth Checklist (SCC). Methods: This quasi-experimental study was conducted between July 2015 and July 2016 at a third-level maternity hospital in northeastern Brazil, where the SCC was implemented. Compliance (underuse and overuse of MgSO 4) was assessed in biweekly samples of 30 deliveries assessed 6 months before and 6 months after SCC implementation, using indicators based on international guidelines. A total of 720 deliveries were assessed over 1 year using an ad hoc application for reviewing medical records. Aggregated adequate use was estimated for the study period, and the time series measurements were compared to a control chart to assess change. Results: The incidence of preeclampsia was 39.9% (287/720). Among these, 64.8% (186/287) had severe signs or symptoms and needed MgSO 4. Underuse (no prescription when needed) of MgSO 4 was observed in 74.7% (139/ 186) of women who needed the drug. Considering all women, non-compliance with the prescription protocol (underuse and overuse) was 20.0% (144/720). After introducing the SCC, the use of MgSO 4 in women with preeclampsia with severe features increased from 19.1 to 34.2% (p = 0.025). Longitudinal analysis showed a significant (p < 0.05) ascending curve of adequate use of MgSO 4 after the SCC was implemented.

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“…World Health Organization suggested the ideal rate for CS procedure be 15% and less considering the benefits and risks of the procedure 2 . The prevalence of caesarean section (CS) has been increasing at an alarming rate across the world 3 . The rate of CS is 55.5% in Brazil, 26.2% in United Kingdom and 53.1% in Turkey 3 .…”

Section: Introductionmentioning

confidence: 99%

Sezaryen ile Doğmuş Genç Erişkinlerin Kardiyovasküler Sistem Özellikleri

Akşıt¹,

Gazı²,

Kırılmaz³

et al. 2020

Namık Kemal Tıp Dergisi

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Aim: Currently, the prevalence of caesarean section (CS) has been increasing at an alarming rate across the world. In parallel with the increasing rate of CS, it is reported that there is an increasing prevalence of obesity, autoimmune and allergic diseases. The purpose of the present study is to analyse whether the cardiovascular system characteristics of young adults born by CS are different from those of young adults born by vaginal delivery (VD). Materials and Methods: A total of 112 participants were included in the study (40 CS group vs 82 VD ie control group). Transthoracic echocardiography and carotid Doppler ultrasonography were performed to the participants. In addition, participants were evaluated with a 24-hour ECG recording. Results: Tricuspid E wave, tricuspid A wave and tricuspid E/A ratio were lower in the CS group compared with the control group (57.6±8.6 vs. 72.4±10.3, p<0.001; 46.7±8.8 vs. 50.6±8.9, p=0.04; 1.2±0.14 vs 1.45±0.88, p<0.001). Epicardial fat tissue thickness were higher in the CS group compared with the control group (4.8±1.3 vs. 3.1±0.8, p<0.001). Conclusion: The results of this study show that cardiovascular system features of the young adults born by CS are different from those born by VD. Further follow-up studies are needed to understand whether these findings will subsequently result in cardiovascular diseases.

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Alarming global rise in caesarean births, figures show

Cited by 36 publications

References 4 publications

Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude

Multicentre cross-sectional study on adverse events and good practices in maternity wards in Brazil and Mexico: same problems, different magnitude

The WHO Safe Childbirth Checklist implementation: impact on the prescription of magnesium sulphate through a one-year longitudinal study

Sezaryen ile Doğmuş Genç Erişkinlerin Kardiyovasküler Sistem Özellikleri

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