Lithuania's experience in reducing caesarean sections among nulliparas

• Main Authors: Justina Kacerauskiene (Author), Meile Minkauskiene (Author), Tahir Mahmood (Author), Egle Bartuseviciene (Author), Dalia R. Railaite (Author), Arnoldas Bartusevicius (Author), Mindaugas Kliucinskas (Author), Ruta J. Nadisauskiene (Author), Kastytis Smigelskas (Author), Kornelija Maciuliene (Author), Grazina Drasutiene (Author), Diana Ramasauskaite (Author)
• Format: Book
• Published: BMC, 2018-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/s12884-018-2052-2; 1471-2393
• Keywords: Caesarean section; Rate; Robson classification; Intervention; Nulliparas; Gynecology and obstetrics; RG1-991
• Source: BMC Pregnancy and Childbirth, Vol 18, Iss 1, Pp 1-7 (2018)

Abstract Background To evaluate the role of the TGCS to reduce the caesarean section (CS) rate among nulliparas (Robson groups 1 and 2) and to find out which group of women have reduced the CS rate by using this tool. Methods The Robson classification was introduced in Lithuanian hospitals prospectively classifying all the deliveries in 2012. The CS rate overall and in each Robson group was calculated and the results were discussed. The analysis was repeated in 2014 and the data from the selected hospitals were compared using MS EXCEL and SPSS 23.0. Results Nulliparas accounted for 43% (3746/8718) and 44.6% (3585/8046) of all the deliveries in 2012 and 2014 years, respectively. The CS rate among nulliparas decreased from 23.9% (866/3626) in 2012 to 19.0% (665/3502) in 2014 (p < 0.001).The greatest decrease in absolute contribution to the overall CS rate was recorded in groups 1 (p = 0.005) and 2B (p < 0.001). Perinatal mortality was 3.5 in 2012 and 3.1 in 2014 per 1000 deliveries (p = 0.764). Conclusion The TGCS can work as an audit intervention that could help to reduce the CS rate without a negative impact on perinatal mortality.