A-C Sans-Mischel1, C Trastour, C Sakarovitch, J Delotte, E Fontas, A Bongain. 1. Service de gynécologie, obstétrique, reproduction et médecine fœtale, hôpital Archet-II, CHU de Nice, 151, route de Saint-Antoine-de-Ginestière, BP 3079, 06202 Nice cedex 3, France.
Abstract
UNLABELLED: Since many years, caesarean section rate has increased in France. The purpose of the study was to compare the different French obstetrical attitudes after a prior caesarean section. METHODS: This retrospective study was performed between March 2008 and February 2010. We collected the answers of a majority of maternity centres contacted with an anonymous questionnaire sent by postal, electronic, fax mails. RESULTS: Of the 194 maternity centres which have responded, there were 37 university hospitals and 312 obstetricians: 75.6% of them worked in public sector and 19.2% in private one. The use of a protocol is registered for 29.6% of questioned obstetricians (only 14% in private sector, P=0.002). Pelvimetry is consistently proposed by 44.4% of them. A trial of labour in case of breech presentation is proposed by 20% of questioned obstetricians, with twin pregnancies by 23.7%, with two prior low-transverse caesarean delivery by 12%, most in university hospitals, level III, with more than 1500 births per year. Induction of labour is allowed by 73.9% of questioned obstetricians, by ocytocics as a majority. Induction by Prostine(®) is underwent by 14.5% of them (24.6% in academic centres, P=0.01), by Propess(®) by 19.2% of them (30% in university hospitals, P=0.008). CONCLUSION: These findings showed that the management of delivery after caesarean section is associated with statistically significant differences in France. These informations are relevant for counselling French obstetrical practices.
UNLABELLED: Since many years, caesarean section rate has increased in France. The purpose of the study was to compare the different French obstetrical attitudes after a prior caesarean section. METHODS: This retrospective study was performed between March 2008 and February 2010. We collected the answers of a majority of maternity centres contacted with an anonymous questionnaire sent by postal, electronic, fax mails. RESULTS: Of the 194 maternity centres which have responded, there were 37 university hospitals and 312 obstetricians: 75.6% of them worked in public sector and 19.2% in private one. The use of a protocol is registered for 29.6% of questioned obstetricians (only 14% in private sector, P=0.002). Pelvimetry is consistently proposed by 44.4% of them. A trial of labour in case of breech presentation is proposed by 20% of questioned obstetricians, with twin pregnancies by 23.7%, with two prior low-transverse caesarean delivery by 12%, most in university hospitals, level III, with more than 1500 births per year. Induction of labour is allowed by 73.9% of questioned obstetricians, by ocytocics as a majority. Induction by Prostine(®) is underwent by 14.5% of them (24.6% in academic centres, P=0.01), by Propess(®) by 19.2% of them (30% in university hospitals, P=0.008). CONCLUSION: These findings showed that the management of delivery after caesarean section is associated with statistically significant differences in France. These informations are relevant for counselling French obstetrical practices.