BACKGROUND: In recent years, rising rates of caesarean section are of concern in the medical community in many countries, especially in Latin America. OBJECTIVE: Determine if there is a difference in the rate of Caesarean sections in a restricted-access hospital (HC) and an open-access hospital (HA) using the Robson classification to explain potential differences. MATERIAL AND METHOD: A prospective cohort study was conducted. This in volved all patients that attended the obstetrics sector in the two hospitals in Buenos Aires where they gave birth between 1 June 2009 and 25h January 2010. The open-access hospital is open to doctors with varying professional training and differing clinical practice. The restricted-access hospital, on the other hand, can only be attended by specified doctors with certain professional training; their medical) conduct is based on service standards and clinical practice. RESULTS: Over the study period 762 patients who fulfilled the study criteria were included from the open-access hospital and 768 from the restricted-access hospital. The global rate of caesarean sections in the HAwas 53.5%, and 48.7% in the HC, RR 1.09 (CI 0.99-1.21) a difference that was not statistically significant (p = 0.058). The onset of spontaneous labour in the HAwas significantly more than in the HC (74.9% vs. 41.8%) RR 2.66 (CU.98-3.57). The induced labour was significantly lower in HA (9,7% vs. 28,3%); RR 0.34 (CI 0.27-0.44). Elective caesarean sections were significantly lower in the HA (15.3% vs. 29.9%) RR 0.51 (CI 0.42-0.62). CONCLUSION: This study reveals a similar rate of caesarean sections in two private hospitals with different systems of care. However, it observed that the HA has a greater tendency to operate on patients at the onset of spontaneous labour and the HC has a greater number of induced labour and elective caesarean section.
BACKGROUND: In recent years, rising rates of caesarean section are of concern in the medical community in many countries, especially in Latin America. OBJECTIVE: Determine if there is a difference in the rate of Caesarean sections in a restricted-access hospital (HC) and an open-access hospital (HA) using the Robson classification to explain potential differences. MATERIAL AND METHOD: A prospective cohort study was conducted. This in volved all patients that attended the obstetrics sector in the two hospitals in Buenos Aires where they gave birth between 1 June 2009 and 25h January 2010. The open-access hospital is open to doctors with varying professional training and differing clinical practice. The restricted-access hospital, on the other hand, can only be attended by specified doctors with certain professional training; their medical) conduct is based on service standards and clinical practice. RESULTS: Over the study period 762 patients who fulfilled the study criteria were included from the open-access hospital and 768 from the restricted-access hospital. The global rate of caesarean sections in the HAwas 53.5%, and 48.7% in the HC, RR 1.09 (CI 0.99-1.21) a difference that was not statistically significant (p = 0.058). The onset of spontaneous labour in the HAwas significantly more than in the HC (74.9% vs. 41.8%) RR 2.66 (CU.98-3.57). The induced labour was significantly lower in HA (9,7% vs. 28,3%); RR 0.34 (CI 0.27-0.44). Elective caesarean sections were significantly lower in the HA (15.3% vs. 29.9%) RR 0.51 (CI 0.42-0.62). CONCLUSION: This study reveals a similar rate of caesarean sections in two private hospitals with different systems of care. However, it observed that the HA has a greater tendency to operate on patients at the onset of spontaneous labour and the HC has a greater number of induced labour and elective caesarean section.
Authors: J C Rivo; M Amyx; V Pingray; R A Casale; A E Fiorillo; H B Krupitzki; J D Malamud; M Mendilaharzu; M L Medina; A B Del Pino; L Ribola; J A Schvartzman; G M Tartalo; M Trasmonte; S Varela; F Althabe; J M Belizán Journal: BJOG Date: 2018-02-22 Impact factor: 6.531
Authors: Agustina Mazzoni; Fernando Althabe; Laura Gutierrez; Luz Gibbons; Nancy H Liu; Ana María Bonotti; Gustavo H Izbizky; Marta Ferrary; Nora Viergue; Silvia I Vigil; Gabriela Zalazar Denett; José M Belizán Journal: BMC Pregnancy Childbirth Date: 2016-02-08 Impact factor: 3.007
Authors: Ibrahim Abdelazim; Mohamed M M Farghali; Assem A M Elbiaa; Khaled M Abdelrazak; Mohamed Hussain; Amr H Yehia; Mona Rashad Journal: Arch Med Sci Date: 2017-04-20 Impact factor: 3.318
Authors: Melissa M Amyx; Fernando Althabe; Julie Rivo; Verónica Pingray; Nicole Minckas; María Belizán; Luz Gibbons; Gerardo T Murga; Ángel E Fiorillo; Julio D Malamud; Roberto A Casale; Gabriela Cormick; José M Belizán Journal: Matern Child Health J Date: 2021-01-03
Authors: Ana Pilar Betrán; Nadia Vindevoghel; Joao Paulo Souza; A Metin Gülmezoglu; Maria Regina Torloni Journal: PLoS One Date: 2014-06-03 Impact factor: 3.240