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Clinical practice guideline for cesarean section due to cephalopelvic disproportion.
Artículo en Inglés | IMSEAR | ID: sea-43391
ABSTRACT

OBJECTIVES:

To evaluate the effect of the Clinical Practice Guideline (CPG) for cesarean section due to Cephalopelvic Disproportion (CPD) on physician compliance, pregnancy outcomes and cesarean section rate. The study also wants to identify factors associated with physician non-compliance. MATERIAL AND

METHOD:

455 medical records of women undergoing a cesarean section due to CPD from January 1, 2002 to December 31, 2003 were reviewed The CPG was implemented on January 1, 2003. The pregnant outcomes of women who delivered from January 1, 2002 to December 31, 2002 were used for comparison. The outcome measurements were physician compliance, pregnancy outcomes and cesarean section rates. Multivariate logistic regression analysis was used to identify factors associated with physician non-compliance. Independent variables included private care, parity, maternal height, Bishop score, maternal age and estimated fetal weight.

RESULTS:

The compliance rate was 83%. Physician compliance in private practice was lower than in non-private practice (76.6% VS 92.4%). Pregnancy outcomes were not different between the two periods. The cesarean section rates before and after implementation of the CPG were 8.4% and 8.5%, respectively. Private practice, poor Bishop score and estimated fetal weight < or = 3500 g were significant predictors of physician non-compliance.

CONCLUSION:

The compliance rate was high, but the cesarean section rate due to CPD did not significantly change within a one year period There was no adverse outcome. Physician non-compliance was more common in private practice. Poor Bishop score and high estimated fetal weight were significant predictors.
Asunto(s)
Texto completo: Disponible Índice: IMSEAR (Asia Sudoriental) Asunto principal: Tailandia / Pautas de la Práctica en Medicina / Femenino / Humanos / Embarazo / Resultado del Embarazo / Modelos Logísticos / Cesárea / Factores de Riesgo / Guías de Práctica Clínica como Asunto Tipo de estudio: Estudio de etiología / Estudios de evaluación / Guía de Práctica Clínica / Estudio pronóstico País/Región como asunto: Asia Idioma: Inglés Año: 2006 Tipo del documento: Artículo

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Texto completo: Disponible Índice: IMSEAR (Asia Sudoriental) Asunto principal: Tailandia / Pautas de la Práctica en Medicina / Femenino / Humanos / Embarazo / Resultado del Embarazo / Modelos Logísticos / Cesárea / Factores de Riesgo / Guías de Práctica Clínica como Asunto Tipo de estudio: Estudio de etiología / Estudios de evaluación / Guía de Práctica Clínica / Estudio pronóstico País/Región como asunto: Asia Idioma: Inglés Año: 2006 Tipo del documento: Artículo