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RETROSPECTIVE EVALUATION OF CHANGING RATES FOR OPERATIVE VAGINAL DELIVERY OVER THE DECADES IN A SINGLE TERTIARY HEALTH CARE CENTER

Year 2019, Volume: 82 Issue: 3, 139 - 143, 16.07.2019
https://doi.org/10.26650/IUITFD.2018.0022

Abstract

Objective: To evaluate the changing rates for operative vaginal delivery (OVD) over the decades in our institution. Material and Methods: This is a retrospective and descriptive study. A total of 10458 births in 1976, 1986, 1996, 2006 and 2016 were included in the study. Cases were divided into five groups according to years of delivery: group 1 (1976, n=2668), group 2 (1986, n=2393), group 3 (1996, n=1751), group 4 (2006, n=1751), and group 5 (2016, n=1895). The percentage of total operative deliveries, the percentage of births with forceps, the percentage of vacuum extractions and the percentage of births by cesarean were compared between the study years. Results: The frequency of OVD was 16.4%, 17.1%, 5.1%, 1.9% and 0% in 1976, 1986, 1996, 2006 and 2016, respectively. The frequency of forceps applications in OVDs was 99.3%, 99.58%, 99.83%, 99.94% and 0%, respectively. The caesarean rates in the study years were 11.4%, 19.2%, 44.7%, 69.3% and 77.9%, respectively. There was a statistically significant difference in the percentage of total operative deliveries, percentage of births with forceps, percentage of vacuum extractions, and percentage of cesarean delivery (p<0.001). Conclusion: As in the rest of the world, OVD applications within the decades have decreased dramatically, and cesarean delivery has increased significantly. Supporting OVD practices and increasing the number of physicians with sufficient experience in this area may contribute to reducing the increased cesarean section frequency. 

References

  • 1. Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 154: operative vaginal delivery. Obstet Gynecol 2015;126(1):56-65.
  • 2. Martin JA, Hamilton BE, Osterman MJ, Driscoll AK, Mathews TJ. Births: final data for 2015 Natl Vital Stat Rep 2017;66(1):1.
  • 3. Clark SL, Belfort MA, Hankins GD, Meyers JA, Houser FM. Variation in the rates of operative delivery in the United States. Am J Obstet Gynecol 2007;196(6): 526-1.
  • 4. Ameh CA, Weeks AD. The role of instrumental vaginal delivery in low resource settings. BJOG 2009;116(Suppl. 1): 22-5.
  • 5. Fauveau V. Is vacuum extraction still known, taught and practiced? A worldwide KAP survey. Int J Gyn Obstet 2006;94(2):185-9.
  • 6. O’Mahony F, Hofmeyr GJ, Menon V. Choice of instruments for assisted vaginal delivery. Cochrane Database Syst Rev 2010;(11):CD005455.
  • 7. Queenan JT. How to stop the relentless rise in cesarean deliveries. Obstet Gynecol 2011;118(2 Pt 1):199-200.
  • 8. Beksac MS, Tanacan A, Bacak HO, Leblebicioglu K. Computerized prediction system for the route of delivery (vaginal birth versus cesarean section). J Perinat Med 2018;46(8):881-4.
  • 9. Caughey AB, Cahill AG, Guise JM, Rouse DJ American College of Obstetricians and Gynecologists. Safe prevention of the primary cesarean delivery. Am J Obstet Gynecol 2014;210(3):179-93.
  • 10. Spong CY, Berghella V, Wenstrom KD, Mercer BM, Saade GR. Preventing the first cesarean delivery: Summary of a joint Eunice Kennedy Shriver national institute of child health and human development, Society for MaternalFetal Medicine, and American College of Obstetricians and Gynecologists Workshop. Obstet Gynecol 2012;120(5):1181.
  • 11. Poignant M, Hjelmstedt A, Ekéus C. Indications for operative delivery between 1999-2010 and induction of labor and epidural analgesia on the risk of operative delivery–A population based Swedish register study. Sex Reprod Healthc 2012;3(4): 129-34.
  • 12. Pfuntner A, Wier LM, Stocks C. Most Frequent Procedures Performed in U.S. Hospitals, 2011, Statistical Brief #165. Agency for Healthcare Research and Quality (US). Khanna G, Mackay-Smith V, editor. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville, MD; 2013. Bookshelf ID: NBK174682PMID: 24354027.
  • 13. Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PloS one 2016;11(2): e0148343.
  • 14. Demissie K, Rhoads G, Smulian JC, Balasubramanian BA, Gandhi K, Joseph KS, Kramer M. Operative vaginal delivery and neonatal and infant adverse outcomes: population based retrospective analysis. BMJ 2004;329:24.
  • 15. Towner D, Castro MA, Eby-Wilkens E, Gilbert WM. Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med 1999;341(23):1709-14.
  • 16. Pergialiotis V, Vlachos DG, Rodolakis A, Haidopoulos D, Thomakos N, Vlachos GD, First versus second stage C/S maternal and neonatal morbidity: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2014;175:15-24.

ÜÇÜNCÜ BASAMAK BİR MERKEZDEKİ OPERATİF VAJİNAL DOĞUM SIKLIĞININ DEKATLAR ARASINDAKİ DEĞİŞİMİNİN RETROSPEKTİF OLARAK İNCELENMESİ

Year 2019, Volume: 82 Issue: 3, 139 - 143, 16.07.2019
https://doi.org/10.26650/IUITFD.2018.0022

Abstract

Amaç: Kliniğimizdeki operatif vajinal doğum (OVD) sıklığının, dekatlar içerisindeki değişimini incelemektir. Gereç ve Yöntemler: Mevcut çalışma retrospektif ve tanımlayıcı bir araştırmadır. Çalışmaya 1976, 1986, 1996, 2006 ve 2016 yıllarında gerçekleşmiş olan toplam 10458 doğum dahil edilmiştir. Vakalar doğumun gerçekleştiği yıllara göre beş gruba ayrılmıştır: grup 1 (1976, n=2668), grup 2 (1986, n=2393), grup 3 (1996, n=1751), grup 4 (2006, n=1751) ve grup 5 (2016, n=1895). Çalışma yılları arasında toplam operatif doğumların yüzdesi, forseps ile doğumların yüzdesi, vakum ekstraksiyonlarının yüzdesi ve sezaryen ile doğumların yüzdesi karşılaştırılmıştır. Bulgular: OVD sıklığı 1976, 1986, 1996, 2006 ve 2016 yıllarında sırası ile %16,4, %17,1, %5,1, %1,9 ve %0 olarak bulunmuştur. OVD’lar içerisinde forseps uygulamalarının sıklığı çalışma yıllarına göre ise sırasıyla %99,3, %99,58, %99,83, %99,94 ve %0 olarak bulunmuştur. Çalışma yıllarındaki sezaryen oranları ise sırasıyla %11,4, %19,2, %44,7, %69,3 ve %77,9’dur. Çalışma yılları arasında toplam operatif doğumların yüzdesi, forseps ile doğumların yüzdesi, vakum ekstraksiyonlarının yüzdesi ve sezaryen ile doğumların yüzdesi açısından istatistiksel olarak anlamlı fark mevcuttur (p<0,001). Sonuç: Tüm dünyada olduğu gibi kliniğimizde dekatlar içerisinde OVD uygulamaları dramatik olarak azalmış, sezaryen ile doğum ise belirgin olarak artmıştır. OVD uygulamalarının desteklenmesi ve bu alanda yeterli tecrübeye sahip hekimlerin sayısının arttırılması artan sezaryen sıklığını azaltmaya katkıda bulunabilir. 

References

  • 1. Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 154: operative vaginal delivery. Obstet Gynecol 2015;126(1):56-65.
  • 2. Martin JA, Hamilton BE, Osterman MJ, Driscoll AK, Mathews TJ. Births: final data for 2015 Natl Vital Stat Rep 2017;66(1):1.
  • 3. Clark SL, Belfort MA, Hankins GD, Meyers JA, Houser FM. Variation in the rates of operative delivery in the United States. Am J Obstet Gynecol 2007;196(6): 526-1.
  • 4. Ameh CA, Weeks AD. The role of instrumental vaginal delivery in low resource settings. BJOG 2009;116(Suppl. 1): 22-5.
  • 5. Fauveau V. Is vacuum extraction still known, taught and practiced? A worldwide KAP survey. Int J Gyn Obstet 2006;94(2):185-9.
  • 6. O’Mahony F, Hofmeyr GJ, Menon V. Choice of instruments for assisted vaginal delivery. Cochrane Database Syst Rev 2010;(11):CD005455.
  • 7. Queenan JT. How to stop the relentless rise in cesarean deliveries. Obstet Gynecol 2011;118(2 Pt 1):199-200.
  • 8. Beksac MS, Tanacan A, Bacak HO, Leblebicioglu K. Computerized prediction system for the route of delivery (vaginal birth versus cesarean section). J Perinat Med 2018;46(8):881-4.
  • 9. Caughey AB, Cahill AG, Guise JM, Rouse DJ American College of Obstetricians and Gynecologists. Safe prevention of the primary cesarean delivery. Am J Obstet Gynecol 2014;210(3):179-93.
  • 10. Spong CY, Berghella V, Wenstrom KD, Mercer BM, Saade GR. Preventing the first cesarean delivery: Summary of a joint Eunice Kennedy Shriver national institute of child health and human development, Society for MaternalFetal Medicine, and American College of Obstetricians and Gynecologists Workshop. Obstet Gynecol 2012;120(5):1181.
  • 11. Poignant M, Hjelmstedt A, Ekéus C. Indications for operative delivery between 1999-2010 and induction of labor and epidural analgesia on the risk of operative delivery–A population based Swedish register study. Sex Reprod Healthc 2012;3(4): 129-34.
  • 12. Pfuntner A, Wier LM, Stocks C. Most Frequent Procedures Performed in U.S. Hospitals, 2011, Statistical Brief #165. Agency for Healthcare Research and Quality (US). Khanna G, Mackay-Smith V, editor. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Rockville, MD; 2013. Bookshelf ID: NBK174682PMID: 24354027.
  • 13. Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PloS one 2016;11(2): e0148343.
  • 14. Demissie K, Rhoads G, Smulian JC, Balasubramanian BA, Gandhi K, Joseph KS, Kramer M. Operative vaginal delivery and neonatal and infant adverse outcomes: population based retrospective analysis. BMJ 2004;329:24.
  • 15. Towner D, Castro MA, Eby-Wilkens E, Gilbert WM. Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med 1999;341(23):1709-14.
  • 16. Pergialiotis V, Vlachos DG, Rodolakis A, Haidopoulos D, Thomakos N, Vlachos GD, First versus second stage C/S maternal and neonatal morbidity: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2014;175:15-24.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section RESEARCH
Authors

Atakan Tanaçan 0000-0001-8209-8248

Mehmet Sinan Beksaç This is me 0000-0001-6362-787X

Publication Date July 16, 2019
Submission Date October 17, 2019
Published in Issue Year 2019 Volume: 82 Issue: 3

Cite

APA Tanaçan, A., & Beksaç, M. S. (2019). ÜÇÜNCÜ BASAMAK BİR MERKEZDEKİ OPERATİF VAJİNAL DOĞUM SIKLIĞININ DEKATLAR ARASINDAKİ DEĞİŞİMİNİN RETROSPEKTİF OLARAK İNCELENMESİ. Journal of Istanbul Faculty of Medicine, 82(3), 139-143. https://doi.org/10.26650/IUITFD.2018.0022
AMA Tanaçan A, Beksaç MS. ÜÇÜNCÜ BASAMAK BİR MERKEZDEKİ OPERATİF VAJİNAL DOĞUM SIKLIĞININ DEKATLAR ARASINDAKİ DEĞİŞİMİNİN RETROSPEKTİF OLARAK İNCELENMESİ. İst Tıp Fak Derg. July 2019;82(3):139-143. doi:10.26650/IUITFD.2018.0022
Chicago Tanaçan, Atakan, and Mehmet Sinan Beksaç. “ÜÇÜNCÜ BASAMAK BİR MERKEZDEKİ OPERATİF VAJİNAL DOĞUM SIKLIĞININ DEKATLAR ARASINDAKİ DEĞİŞİMİNİN RETROSPEKTİF OLARAK İNCELENMESİ”. Journal of Istanbul Faculty of Medicine 82, no. 3 (July 2019): 139-43. https://doi.org/10.26650/IUITFD.2018.0022.
EndNote Tanaçan A, Beksaç MS (July 1, 2019) ÜÇÜNCÜ BASAMAK BİR MERKEZDEKİ OPERATİF VAJİNAL DOĞUM SIKLIĞININ DEKATLAR ARASINDAKİ DEĞİŞİMİNİN RETROSPEKTİF OLARAK İNCELENMESİ. Journal of Istanbul Faculty of Medicine 82 3 139–143.
IEEE A. Tanaçan and M. S. Beksaç, “ÜÇÜNCÜ BASAMAK BİR MERKEZDEKİ OPERATİF VAJİNAL DOĞUM SIKLIĞININ DEKATLAR ARASINDAKİ DEĞİŞİMİNİN RETROSPEKTİF OLARAK İNCELENMESİ”, İst Tıp Fak Derg, vol. 82, no. 3, pp. 139–143, 2019, doi: 10.26650/IUITFD.2018.0022.
ISNAD Tanaçan, Atakan - Beksaç, Mehmet Sinan. “ÜÇÜNCÜ BASAMAK BİR MERKEZDEKİ OPERATİF VAJİNAL DOĞUM SIKLIĞININ DEKATLAR ARASINDAKİ DEĞİŞİMİNİN RETROSPEKTİF OLARAK İNCELENMESİ”. Journal of Istanbul Faculty of Medicine 82/3 (July 2019), 139-143. https://doi.org/10.26650/IUITFD.2018.0022.
JAMA Tanaçan A, Beksaç MS. ÜÇÜNCÜ BASAMAK BİR MERKEZDEKİ OPERATİF VAJİNAL DOĞUM SIKLIĞININ DEKATLAR ARASINDAKİ DEĞİŞİMİNİN RETROSPEKTİF OLARAK İNCELENMESİ. İst Tıp Fak Derg. 2019;82:139–143.
MLA Tanaçan, Atakan and Mehmet Sinan Beksaç. “ÜÇÜNCÜ BASAMAK BİR MERKEZDEKİ OPERATİF VAJİNAL DOĞUM SIKLIĞININ DEKATLAR ARASINDAKİ DEĞİŞİMİNİN RETROSPEKTİF OLARAK İNCELENMESİ”. Journal of Istanbul Faculty of Medicine, vol. 82, no. 3, 2019, pp. 139-43, doi:10.26650/IUITFD.2018.0022.
Vancouver Tanaçan A, Beksaç MS. ÜÇÜNCÜ BASAMAK BİR MERKEZDEKİ OPERATİF VAJİNAL DOĞUM SIKLIĞININ DEKATLAR ARASINDAKİ DEĞİŞİMİNİN RETROSPEKTİF OLARAK İNCELENMESİ. İst Tıp Fak Derg. 2019;82(3):139-43.

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