Recommendations of the Polish Society of Gynecologists and Obstetricians regarding caesarean sections

Wielgoś, Mirosław; Bomba‐Opoń, Dorota; Bręborowicz, Grzegorz H.; Czajkowski, Krzysztof; Dębski, Romuald; Leszczyńska‐Gorzelak, Bożena; Oszukowski, Przemysław; Radowicki, Stanisław; Zimmer, Mariusz

doi:10.5603/gp.a2018.0110

Cited by 35 publications

(46 citation statements)

References 57 publications

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“…According to the literature, the risk factors for UUR are as follows: high parity, use of uterotonic drugs, advanced maternal age, dystocia, macrosomia and possibly short inter-pregnancy intervals [1,7,8,10]. In agreement with the literature, the causes of the UUR's in the present study included advanced age, grand multiparity, uncontrolled labour induction, cephalopelvic disproportion and malpresentation.…”

Section: Discussionsupporting

confidence: 85%

Unscarred uterine rupture and subsequent pregnancy outcome — a tertiary centre experience

et al. 2020

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Objectives: The aim of this study was to investigate the incidence, etiology and obstetric outcomes of rupture in unscarred uterine rupture and in those with a history of uterine rupture Material and methods: The hospital records of women who had delivered between May 2005 and May 2017 at a tertiary center were examined retrospectively. Data on patients with unscarred uterine rupture in pregnancy who had undergone fertility-preserving surgery were evaluated. Results: During the study period, 185,609 deliveries occurred. Of those, unscarred uterine rupture has occurred in 67 women. There were no ruptures reported in nulliparous women. The rupture was observed in the isthmic region in 60 (89.6%) patients and in the fundus in 7 (10.4%) patients. Thirty-eight (56.7%) patients had undergone a total or subtotal hysterectomy, and 29 (43.3%) patients had received primary repair. Ten patients had reconceived after the repair. Of these, eight patients who had a history of isthmic rupture, successfully delivered by elective C-section at 36-37 wk. of gestation, and two experienced recurrent rupture at 33 and 34 wk. of gestation, respectively. Both patients had a history of fundal rupture, and their inter-pregnancy interval was 9 and 11 mo., respectively. Conclusions: The incidence of rupture in unscarred pregnant uteri was found to be one per 2,770 deliveries. Owing to the high morbidity, regarding more than half of the cases with rupture eventuated in hysterectomy, clinicians should be prudent in induction of labour for multiparous women since it was the main cause of rupture in this series. Short inter-pregnancy intervals and history of fundal rupture may confer a risk for rupture recurrence. Those risk factors for recurrence should be validated in another studies.

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Section: Discussionsupporting

confidence: 85%

Unscarred uterine rupture and subsequent pregnancy outcome — a tertiary centre experience

et al. 2020

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“…Sixteen of these maternity units are in Warsaw, catering for approximately 21,000 births per annum [33]. In 2018, the caesarean section (CS) rate was 43.85%, and labour induction and augmentation rates were 43% and 61%, respectively [4,34].…”

Section: Study Design and Settingmentioning

confidence: 99%

Oxytocin administration for induction and augmentation of labour in Polish maternity units– an observational study

Baranowska

Kajdy²,

Kiersnowska

et al. 2020

Preprint

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BackgroundThere is not enough data regarding practices and protocols that healthcare personnel follow and the amount of oxytocin that women receive during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The aim of the study was to evaluate oxytocin supply practices of oxytocin for labour induction and augmentation in Polish maternity units.MethodsThe article presents a prospective observational study. Data collection took place in two selected maternity units between January 15 and July 31, 2019 (n=545). Inclusion criteria were women in term pregnancies, undergoing oxytocin induction or augmentation of labour. Exclusion criteria were women who were in preterm labour, aged less than 18 years, and women whose baby was known to have a malformation. ResultsThe average total amount of oxytocin administrated to women before birth was 7,329µg following labour induction and 3.952µg following labour augmentation. The actual administration of oxytocin deviated both from the unit and national guidelines in 93,6% of all observed labours. We found no statistically significant correlation between the amount of oxytocin administered and mode of delivery, immediate postpartum blood loss or Apgar scores. There was no observed effect of total oxytocin on short-term perinatal outcomes. Hospitals with similar protocols did not differ significantly in terms of total oxytocin amount, induction to stimulation ratio—the only observed difference was the mode of delivery. ConclusionsThere is a need for a thorough analysis to find out the reasons for the observed discrepancies between protocols and practice.

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“…The CB rate in Poland steadily increased between 2010 and 2015 by 24% (up from 34% to 42%) 17 . This trend has remained unchanged, and currently, in Poland, the CB rate is 43% 18 —a rate that is much higher than the European average of 27% and that is twice the rate reported in countries with the lowest perinatal mortality rates, including Finland (16%), Norway (16%), and Iceland (16%). The Polish data are similar to those of South‐Eastern European countries, including Bulgaria (43%), Romania (45%), Hungary (39%), and Cyprus (56%) 6,17 …”

Section: Introductionmentioning

confidence: 95%

Preferences of women with low obstetric risk for cesarean or vaginal birth in Poland: Areas for intervention

Michalik

Wójcicka

Czerwińska-Osipiak

et al. 2021

Birth

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Background In Poland, the rate of cesarean birth (CB) is 43%, which is much higher than the European average of 27%. Optimizing the CB birth rate is of critical importance, especially among women with low‐risk pregnancies. However, the determinants of cesarean preference among low‐risk women in Poland have not been well explored. Methods This cross‐sectional study included 1011 pregnant women and aimed to identify associations between selected determinants of women's preferences for CB vs. vaginal birth (VB) in Poland. A descriptive questionnaire was distributed online, and a theoretical model was validated against empirically gathered data. Group comparisons were performed using the Welch t test for continuous data or chi‐square test for categorical data. All statistical analyses were performed using R (R Core Team, 2018). Results The mean age of women preferring CB (30.46 years) was 1.25 years higher than that of women preferring VB (29.21 years). Pregnant women who expressed a preference for CB tended to be multigravid, inhabited cities, and were characterized by higher levels of anxiety and depression. Moreover, the majority of women who underwent a previous CB asserted their intention to repeat the procedure for the current pregnancy. Conclusions The primary factors that were correlated with high CB preference among the low‐risk group included age, previous childbirth experiences, and anxiety. The underlying reasons that drive birth preferences remain poorly understood. However, women who have previously undergone difficult childbirth experiences and are afraid of pain require specialized care.

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Recommendations of the Polish Society of Gynecologists and Obstetricians regarding caesarean sections

Cited by 35 publications

References 57 publications

Unscarred uterine rupture and subsequent pregnancy outcome — a tertiary centre experience

Unscarred uterine rupture and subsequent pregnancy outcome — a tertiary centre experience

Oxytocin administration for induction and augmentation of labour in Polish maternity units– an observational study

Preferences of women with low obstetric risk for cesarean or vaginal birth in Poland: Areas for intervention

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