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Title: Interinstitutional variations in mode of birth after a previous caesarean section : a cross-sectional study in six German hospitals
Authors : Gross, Mechthild Maria
Matterne, Andrea
Berlage, Silvia
Kaiser, Annette
Lack, Nicholas
Macher-Heidrich, Susanne
Misselwitz, Björn
Bahlmann, Franz
Falbrede, Jörg
Hillemanns, Peter
von Kaisenberg, Constantin
von Koch, Franz Edler
Schild, Ralf L.
Stepan, Holger
Devane, Declan
Mikolajczyk, Rafael
Published in : Journal of Perinatal Medicine
Volume(Issue) : 43
Issue : 2
Pages : 177
Pages to: 184
Publisher / Ed. Institution : de Gruyter
Issue Date: 2015
License (according to publishing contract) : CC BY-NC-ND 4.0: Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International
Type of review: Peer review (Publication)
Language : English
Subjects : Cesarean section, repeat; Cross-sectional studies; Pregnancy; Vaginal birth after cesarean; Mode of birth
Subject (DDC) : 618.4: Childbirth
Abstract: Aims: Regional and interinstitutional variations have been recognized in the increasing incidence of caesarean section. Modes of birth after previous caesarean section vary widely, ranging from elective repeat caesarean section (ERCS) and unplanned repeat caesarean section (URCS) after trial of labour to vaginal birth after caesarean section (VBAC). This study describes interinstitutional variations in mode of birth after previous caesarean section in relation to regional indicators in Germany. Material and methods: A cross-sectional study using the birth registers of six maternity units (n=12,060) in five different German states (n=370,209). Indicators were tested by χ2 and relative deviations from regional values were expressed as relative risks and 95% confidence intervals. Results: The percentages of women in the six units with previous caesarean section ranged from 11.9% to 15.9% (P=0.002). VBAC was planned for 36.0% to 49.8% (P=0.003) of these women, but actually completed in only 26.2% to 32.8% (P=0.66). Depending on the indicator, the units studied deviated from the regional data by up to 32% [relative risk 0.68 (0.47–0.97)] in respect of completed VBAC among all initiated VBAC. Conclusions: There is substantial interinstitutional variation in mode of birth following previous caesarean section. This variation is in addition to regional patterns.
Departement: Gesundheit
Organisational Unit: Institute of Midwifery (IHB)
Publication type: Article in scientific Journal
DOI : 10.1515/jpm-2014-0108
ISSN: 1619-3997
Appears in Collections:Publikationen Gesundheit

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