Factors associated with cesarean sections in a public hospital in Rio de Janeiro, Brazil

d’Orsi, Eleonora; Chor, Dóra; Giffin, Karen; Angulo-Tuesta, Antonia; Barbosa, Gisele Peixoto; Gama, Andréa de Sousa; Reis, Ana Cristina

doi:10.1590/s0102-311x2006001000012

Cited by 43 publications

(49 citation statements)

References 28 publications

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“…Other studies have identifi ed them as risk factors, [6][7][8]10 and in the present study this was seen in the public model, except for skin color. As in other child or mother outcomes, 13 better-off women are more likely to have a cesarean section.…”

Section: Discussionsupporting

confidence: 64%

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Risk factors for cesarean section by category of health service

et al. 2010

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OBJECTIVE:To analyze the rate of cesarean section and differences in risk factors by category of health service, either public or private. METHODS:A cross-sectional study was carried out including all pregnant women in labor admitted to hospitals in the city of Rio Grande, Southern Brazil, between January 1 and December 31, 2007. A pre-coded and pretested questionnaire was used to collect on social, demographic, obstetric and newborn care information. Two regression models were constructed: one for public users and the other one for private ones. Poisson regression was used in each model in the multivariate analysis. Prevalence rates and 95% confi dence intervals were calculated for each adjusted factor. RESULTS:The rate of cesarean section was 43% and 86% among public and private users. Sociodemographic factors and twin births have a more signifi cant impact among public users as well as number of pregnancies (25% vs. 13% reduction in public and private users, respectively) and previous cesarean section (86% vs. 24% increase in public and private users, respectively). Prenatal care visits and hospital admissions affected the outcome only in women users of public services. CONCLUSIONS:Cesarean section rates were high in both groups studied, but it was twice as high among women cared in the private sector. Associated factors differ in magnitude by category of service used. Some of the reasons associated with this high rate are related to health service characteristics.22,25 A recent study of the Brazilian National Supplemental Health Agency (ANS, which regulates private insurance) reported that cesarean section rates among privatelyinsured women were as high as 80% in 2006 a while it is was 26% in the public Brazilian National Health System (SUS), b a rate that is high but closer to that recommended.Although the same surgical procedure is performedand sometimes they are performed by the same doctors RESUMO OBJETIVO: Analisar a taxa de cesárea e fatores associados à sua ocorrência segundo serviço de saúde utilizado, público ou privado. MÉTODOS:Foi realizado estudo transversal entre 1º de janeiro e 31 de dezembro de 2007 com todas as gestantes que deram à luz nos hospitais da cidade de Rio Grande, RS. As gestantes foram entrevistadas, utilizando-se um questionário testado e pré-codifi cado com questões sociodemográfi cas, obstétricas e relacionadas ao recém-nascido. Foram desenvolvidos dois modelos de predição, um para as gestantes internadas pelo Sistema Único de Saúde (público) e outro para as gestantes internadas em serviços privados. Em cada modelo foi realizada uma análise multivariada utilizando a regressão de Poisson, calculando-se as razões de prevalência e seus respectivos intervalos com 95% de confi ança. RESULTADOS:A taxa de cesárea para o grupo público foi 43% enquanto no grupo privado foi 86%. Os fatores sociodemográfi cos e o parto gemelar foram mais importantes no modelo público, assim como o número gravidezes (redução de 25% vs. 13% no grupo privado) e cesárea prévia (incremento de 86% vs. ...

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Section: Discussionsupporting

confidence: 64%

“…Additional issues associated to cesarean sections are obstetric and newborn factors, which were also identifi ed in other studies 6,10,11,22 as major determinant of cesarean section rate in both groups. However, there were differences according to the category of health service.…”

Section: Discussionmentioning

confidence: 53%

Risk factors for cesarean section by category of health service

et al. 2010

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“…Through multivariate logistic regression analyses, the authors found a positive association for cesarean sections in women older than 35 years old (OR = 7.3) and for primiparous women within the multiparous reference category (OR = 6.7). 17 In addition, a sample of 15,336 women in a general hospital (therefore, not a maternity), Padua et al 18 found a significant association for the more advanced age groups, stratified as 20 to 24 years old (OR = 1.26), 25 to 29 (OR = 1.54), 30 to 34 (OR = 1.82), and 35 years and more (OR = 2.05). The same study found a significant association for the married women (OR = 1.25) and for a greater number of prenatal consultations (OR = 1.24).…”

Section: Odds Ratiomentioning

confidence: 99%

Factors associated to the type of childbirth in public and private hospitals in Brazil

Guimarães

Silva

Dutra

et al. 2017

Rev. Bras. Saude Mater. Infant.

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“…Igualmente Lopez-Zeno y col. (17) no demuestran algún efecto en la tasa de cesáreas. D'orsi y col. (18) encuentran que la amniotomía, por el contrario, es un factor protector de cesárea, mediante un análisis de regresión.…”

Section: El De Fraser Y Col (2) Es Uno De Los Más Importantes Ensayounclassified

¿Es útil la amniotomía de rutina en el trabajo de parto de inicio espontáneo? Una revisión de la literatura

Ventura

Lam-Figueroa

2013

An Fac med

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ResumenLa amniotomía de rutina o sistemática, practicada en gestantes con trabajo de parto de inicio espontáneo, se da en gran parte de hospitales del Perú y el mundo, documentándose su prevalencia hasta en 77%. Sin embargo, poco se conoce acerca de los beneficios y daños que puede ocasionar en el feto y en la madre. Se realizó una búsqueda de la literatura médica, con la finalidad de encontrar evidencia científica sólida que respalde o rechace esta práctica. Se llega a la conclusión que la amniotomía practicada sistemáticamente altera la evolución fisiológica del trabajo de parto, acortándolo hasta en 50 minutos en promedio; sin embargo, este acortamiento no tiene trascendencia clínica ni para el feto ni para la madre. Por el contrario, su práctica de rutina puede aumentar el número de partos disfuncionales y el puntaje Ápgar menor de siete a los cinco minutos. Palabras clave: Amniotomía; distocia; trabajo de parto. AbstractSystematic amniotomy in pregnant women with spontaneous labor is largely practiced in Peruvian and world hospitals with documented prevalence up to 77%. Little is known on benefits and harms resulting to both fetus and mother. We searched the medical literature in order to find solid evidence to support or reject this practice. We conclude that systematic amniotomy alters the physiological evolution of labor shortening it about 50 minutes average. However, this has no clinical significance on both fetus and mother. Conversely, routine practice may increase incidence of dysfunctional labor and five minutes less than seven Apgar score.Key words: Amniotomy; dystocia; labor, obstetric. IntroducciónLa amniotomía es la rotura deliberada o artificial de las membranas corioamnióticas, realizada digitalmente o a través de instrumentos denominados amniótomos, como el de Beacham, o empleando pinzas, como la Kelly o Köecher. Es un procedimiento simple, que ha sido utilizado a través de muchos años en pacientes que no han estado en trabajo de parto, para la inducción del parto, solo o asociado a otros fármacos, como prostaglandinas y oxitocina. También, ha sido utilizada en pleno trabajo de parto, para verificar el color y aspecto del líquido amniótico, y para la colocación de electrodos en el cuero cabelludo fetal, con la finalidad de obtener el registro de la actividad cardiaca del feto o para la obtención de sangre y la medición del pH, en el diagnóstico de acidosis fetal (1,2) . Sin embargo, es sabido que el color meconial del líquido amniótico puede no responder a la hipótesis de que el feto está en sufrimiento fetal y se sabe que 20% de los fetos a término presentan líquido meconial, sin otro hallazgo de distrés fetal (3) . Asimismo, ha sido utilizada para aumentar la intensidad y frecuencia de las contracciones uterinas y acortar de esta forma la duración del trabajo de parto (4) . Por otro lado, hay que recordar que fisiológicamente 70% de gestantes llega a dilatación completa con las membranas intactas (5) .En la última década, se ha publicado los informes de varios estudios clínicos aleatorizad...

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Factors associated with cesarean sections in a public hospital in Rio de Janeiro, Brazil

Cited by 43 publications

References 28 publications

Risk factors for cesarean section by category of health service

Risk factors for cesarean section by category of health service

Factors associated to the type of childbirth in public and private hospitals in Brazil

¿Es útil la amniotomía de rutina en el trabajo de parto de inicio espontáneo? Una revisión de la literatura

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