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Re: 7 to 25% CS (was: Denmark the Csection rate...) From: Bernard Cristalli (bcrist@club-internet.fr) Sun Aug 10 12:24:37 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: RModugno@aol.com: "Re: TOL in previous 2nd stage cesarean" Previous message: Robert J. Woolley: "Re: New Weird Case" Maybe in reply to: Bernard Cristalli: "7 to 25% CS (was: Denmark the Csection rate...)" Next in thread: Edwin Bello: "Re: 7 to 25% CS (was: Denmark the Csection rate...)" Edwin Bello wrote: > Do you agree that a 0% c/s is too low? YES > Do you believe hat by doing a c/s with a total placenta previa gives that > infant and mother a better chance. > Do you believe a c/s in a patient at 8 cm for over 2 hours and with an > estimated fetal with of aprox. 8 lbs. increase the infant's chance for a > intact survival? YES > Do you believe that a doing a c/s > when the patient has repetitive late decelerations in a primigravida in > active labor(4cm) will increase the infant's chance? YES > I believe there is a middle ground where > there is a too high a c/s that does not improve neonatal outcome but my > common sense tell me that there is also a too low c/s rate(probably less > than 5%). we are completly in accordance. Please the next time someone talks you about the Dublin study > tell that that it was the increase in c/s they were stating not that c/s do > not improve neonatal outcome. See the abstract: Correlation of decrease in perinatal mortality and increase in cesarean section rates. O'Driscoll K; Foley M Obstet Gynecol, 61(1):1-5 1983 During what has proved to be a critical period in the practice of modern obstetrics, 1965 to 1980, when cesarean birth rates increased dramatically in centers across the United States from less than 5 to more than 15%, the number of infants born in the National Maternity Hospital, Dublin, was 108,987. Although the incidence of cesarean section remained virtually unchanged at 4.2, 4.2, 4.2, and 4.8% in 1965, 1970, 1975, and 1980, respectively, perinatal mortality continued to fall from 42.1 to 36.5, 24.0, and 16.8 per 1000 infants born at 500 g or more. These results do not support the contention that the expansion in cesarean birth rates has contributed significantly to reduced perinatal mortality in recent years. Consideration of indications shows that the threefold difference in cesarean birth rate which now exists between Dublin and similar centers across the United States can be accounted for almost entirely by a different approach to management of labor in nulliparous women, compounded by rigid adherence to precept "once a section, always a section. -- > > remember that the CS rate was circa 5%, at least, in that study . It's > obvious that CS did improve fetal outcome. But above a certain rate the > improvement can come nowhere else than from pediatrics. > In paris there's a surveillance of the CS rates in the different depts > of Ob. It goes from 7 to 25%. And the fetal outcome is the same. The > difference? 7% Depts are chaired by rather obstetrician obgyns and 25% > Depts are chaired by rather surgeon obgyns. -- Bernard Cristalli MD CNGOF AIHP - ACCA Paris - France http://www.obgyn.net/corresp/cristalli.htm Next message: RModugno@aol.com: "Re: TOL in previous 2nd stage cesarean" Previous message: Robert J. Woolley: "Re: New Weird Case" Maybe in reply to: Bernard Cristalli: "7 to 25% CS (was: Denmark the Csection rate...)" Next in thread: Edwin Bello: "Re: 7 to 25% CS (was: Denmark the Csection rate...)"

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