Re: Risks / Benefits of Cesarean -- NEJM
From: Bernard Cristalli (bcrist@club-internet.fr)
Fri Mar 2 01:07:11 2007
We're heading to a 100% C/S rate.
BC
Even Chuck Norris will melt in front of a french baguette
DoctorJoe@aol.com a écrit :
>
> In a message dated 3/1/07 3:36:44 PM, dean@thehuffpeople.net writes:
>
>> Interesting article in today's NEJM about risk/benefits of cesarean.
>>
>> http://content.nejm.org/content/vol356/issue9/index.shtml
>
> And I like the ending. It's the WOMEN who choose to take the risk, for
> possible benefit for the baby.
>
> "But the key question centers on both the number needed to treat to
> avoid one adverse neonatal outcome and the level of risk that is
> currently considered acceptable. As practicing obstetricians, we find
> that the risk that women are now willing to assume in exchange for a
> measure of potential benefit, especially for the neonate, has changed:
> for many, the level of risk of an adverse outcome that was tolerated
> in the past to avoid cesarean delivery is no longer acceptable, and
> the threshold number needed to treat has thus been reset.
>
> In the face of the resulting continued increase in cesarean
> deliveries, our obligation as providers is to educate patients about
> the trade-offs entailed in choosing a particular course or
> intervention and to ensure that their choices are congruent with their
> own philosophy, plans, and tolerance of risk. In areas in which there
> is still uncertainty, we must organize clinical trials that will
> produce the data we require for counseling patients. For the moment,
> however, few of the relevant factors seem likely to change, and the
> cesarean rate can be predicted to continue its climb."
>
> Of course, if we're harassed by 3rd party insurers, busy-body
> regulators and societies, and the like, if WE shy away from a
> C-section, it's ultimately the WOMAN who doesn't get her wish granted.
> So regulation of the doctor is an indirect way to coerce the woman to
> take what she perceives as more risk for her baby. Talk about insidious.
>
> Joe P.
>
> "There are only two things that can cut diamonds: other diamonds, and
> Chuck Norris."
>
