FINDING WAYS TO REDUCE THE FREQUENCY OF CESAREAN SECTION

Дюсембаева, М.Д. and Каббасова, Г.Қ. and Гасанова, Э.З. and Шалбаева, О.И. and Акылжанова, Ж.Е. FINDING WAYS TO REDUCE THE FREQUENCY OF CESAREAN SECTION. Scientific-Practical Journal of Medicine, "Vestnik KazNMU". ISSN 2524 - 0692

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Abstract

Relevance. The most common operation worldwide is cesarean section (CS), over the past thirty years, the operation has become much more frequent – from 7% in 1990 to 21% in 2020, and according to WHO data over the past decade, the frequency of CS has peaked and amounted to 25-30% in economically developed countries. Obstetricians and gynecologists are increasingly concerned about the increasing frequency of long-term complications after surgery. Factors contributing to the increase in frequency include an increase in the average age of women giving birth, obesity, the birth of children over 4000 gy, as well as non–medical problems - an increasing number of lawsuits against specialists in this profession. Goal. Conducting an assessment of the frequency of CS to find ways to reduce this indicator. Material and methods of research. The study materials include documentation of the perinatal center of the 3rd level of the KGP at the Pavlodar Regional Hospital named after G.Sultanov, which included all cases that sought medical help in 2021. A retrospective analysis of the birth histories was performed with a sample of patients with operative delivery, who were divided into 10 groups according to the Robson classification. A total of 6534 birth histories were analyzed, of which the share of operative delivery was 1,350 (20.6%). Clinical, instrumental, and statistical research methods were used. An assessment of the dynamics of the CS frequency index over the past 4 years in this obstetric hospital was carried out. Results. In 2021, the increase in the frequency of CS relative to the total number of operative births is mainly due to 4 groups: 3 (6,37%), 4 (12,66%), 5 (49,62%) and 7 (9.62%). The smallest number of abdominal deliveries relative to the total number of operative deliveries is represented in the following 3 groups: 6 (2,66%), 8 (3,03%), 9 (1,70%). Of the 10 groups presented according to the Robson classification, the largest number fell on the category of women belonging to group 5 - 670 (49.62%), and the smallest - 23 (1.70%) belonging to group 9. Despite the absolute leadership of Group 5, in comparison with 2020, there is a significant decrease in the dynamics of the indicator by 1.3%. There is a decrease in the indicator in dynamics in groups 1, 2, 6 and 10. The main direction in reducing the frequency of CS in groups 1, 2, 6 was ignoring the prolonged latent phase of labor and reducing interventions. The widespread use of the Foley catheter for the purpose of cervical dilation has reduced the growth of operative labor among women of groups 2 and 10. An increase in the frequency of CS in groups 4 and 7 is associated with an increase in the number of clinically narrow pelvis, mainly due to fetuses with macrosomia, as well as with a threatening fetal condition. The indicator of the frequency of CS in the perinatal center of level 3 in dynamics was in 2018 - 26,2%, 2019 - 26,9%, 2020 - 21,6% and 2021 respectively - 20.6%. Conclusions. The main ways to reduce the frequency of CS in the perinatal center of Pavlodar include the following: rational management of labor, ignoring the prolonged latent phase of labor and reducing interventions; increasing deliveries through the natural birth canal in pregnant women with a scar on the uterus using a Foley catheter. Over the past four years, the rate of CS in the perinatal center has decreased from 26.2% to 20.6%, and an individual approach to group 5 patients has reduced the percentage of abdominal births by 1.3%.

Item Type:	Article
Uncontrolled Keywords:	Robson's classification, operative delivery, cesarean section, childbirth, scar on the uterus.
Subjects:	R Medicine > RG Gynecology and obstetrics
Divisions:	Научно-практический журнал "Вестник КазНМУ" > Выпуск №4 2016 год
Depositing User:	Mr Askhat Zhakaev
Date Deposited:	07 Jun 2022 03:00
Last Modified:	07 Jun 2022 03:00
URI:	http://repository.kaznmu.kz/id/eprint/16536

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