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Re: 7 to 25% CS (was: Denmark the Csection rate...) From: Edwin Bello (edbello@mindspring.com) Sun Aug 10 13:58:07 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dean Huffman: "Re: Military Corut Martial For Medical Malpractice" Previous message: RModugno@aol.com: "Re: TOL in previous 2nd stage cesarean" Maybe in reply to: Bernard Cristalli: "7 to 25% CS (was: Denmark the Csection rate...)" Next in thread: Ealgail@aol.com: "Re: 7 to 25% CS (was: Denmark the Csection rate...)" We are in agreement, I have served Quality Assurance(QA) committee for more than 3 year in a row. Currently Chairman of the QA committee and I find very few so called unnecessary c/s. I do see providers trying to improve there statistics thus waiting too long, infant and mom suffer the consequences. I see more late or no c/s than providers doing the c/s too soon. I see everybody talking about numbers but are we comparing the same type of populations? -- Edwin Bello M.D.,F.A.C.O.G. Private Practice Forest Park, Georgia Edbello@mindspring.com -----Original Message----- From: Bernard Cristalli [SMTP:bcrist@club-internet.fr] Sent: Sunday, August 10, 1997 1:25 PM To: Multiple recipients of list Subject: Re: 7 to 25% CS (was: Denmark the Csection rate...) 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: Dean Huffman: "Re: Military Corut Martial For Medical Malpractice" Previous message: RModugno@aol.com: "Re: TOL in previous 2nd stage cesarean" Maybe in reply to: Bernard Cristalli: "7 to 25% CS (was: Denmark the Csection rate...)" Next in thread: Ealgail@aol.com: "Re: 7 to 25% CS (was: Denmark the Csection rate...)"

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