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Reducing primary cesarean delivery rate through implementation of a smart intrapartum surveillance system

The rapid changes in clinical maternity situations that occur in a labor and delivery unit can lead to unpredictable maternal and newborn morbidities. Cesarean section (CS) rate is a key indicator of the accessibility and quality of a labor and delivery unit. This retrospective cross-sectional study...

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Autores principales: Cheng, Po Jen, Cheng, You Hung, Shaw, Steven S. W., Jang, Hung Chi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10336068/
https://www.ncbi.nlm.nih.gov/pubmed/37433963
http://dx.doi.org/10.1038/s41746-023-00867-y
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author Cheng, Po Jen
Cheng, You Hung
Shaw, Steven S. W.
Jang, Hung Chi
author_facet Cheng, Po Jen
Cheng, You Hung
Shaw, Steven S. W.
Jang, Hung Chi
author_sort Cheng, Po Jen
collection PubMed
description The rapid changes in clinical maternity situations that occur in a labor and delivery unit can lead to unpredictable maternal and newborn morbidities. Cesarean section (CS) rate is a key indicator of the accessibility and quality of a labor and delivery unit. This retrospective cross-sectional study assesses the nulliparous, term, singleton, vertex (NTSV) cesarean delivery rates before and after the implementation of a smart intrapartum surveillance system. Research data were collected from the electronic medical records of a labor and delivery unit. The primary outcome was the CS rate of the NTSV population. The data of 3648 women admitted for delivery were analyzed. Of the studied deliveries, 1760 and 1888 occurred during the preimplementation and postimplementation periods, respectively. The CS rate for the NTSV population was 31.0% and 23.3% during the preimplementation and postimplementation periods, respectively, indicating a significant 24.7% (p = 0.014) reduction in CS rate after the implementation of the smart intrapartum surveillance system (relative risk, 0.75; 95% confidence interval, 0.71–0.80). In the NTSV population, the vaginal and CS birth groups, no significant difference in terms of newborn weight, neonatal Apgar scores, composite neonatal adverse outcome indicator, and the occurrence of the following: neonatal intensive care unit admission, neonatal meconium aspiration, chorioamnionitis, shoulder dystocia, perineal laceration, placental abruption, postpartum hemorrhage, maternal blood transfusion, and hysterectomy before and after the implementation of the smart intrapartum surveillance system. This study reveals that the use of the smart intrapartum surveillance system can effectively reduce the primary CS rate for low-risk NTSV pregnancies without significantly affecting perinatal outcomes.
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spelling pubmed-103360682023-07-13 Reducing primary cesarean delivery rate through implementation of a smart intrapartum surveillance system Cheng, Po Jen Cheng, You Hung Shaw, Steven S. W. Jang, Hung Chi NPJ Digit Med Article The rapid changes in clinical maternity situations that occur in a labor and delivery unit can lead to unpredictable maternal and newborn morbidities. Cesarean section (CS) rate is a key indicator of the accessibility and quality of a labor and delivery unit. This retrospective cross-sectional study assesses the nulliparous, term, singleton, vertex (NTSV) cesarean delivery rates before and after the implementation of a smart intrapartum surveillance system. Research data were collected from the electronic medical records of a labor and delivery unit. The primary outcome was the CS rate of the NTSV population. The data of 3648 women admitted for delivery were analyzed. Of the studied deliveries, 1760 and 1888 occurred during the preimplementation and postimplementation periods, respectively. The CS rate for the NTSV population was 31.0% and 23.3% during the preimplementation and postimplementation periods, respectively, indicating a significant 24.7% (p = 0.014) reduction in CS rate after the implementation of the smart intrapartum surveillance system (relative risk, 0.75; 95% confidence interval, 0.71–0.80). In the NTSV population, the vaginal and CS birth groups, no significant difference in terms of newborn weight, neonatal Apgar scores, composite neonatal adverse outcome indicator, and the occurrence of the following: neonatal intensive care unit admission, neonatal meconium aspiration, chorioamnionitis, shoulder dystocia, perineal laceration, placental abruption, postpartum hemorrhage, maternal blood transfusion, and hysterectomy before and after the implementation of the smart intrapartum surveillance system. This study reveals that the use of the smart intrapartum surveillance system can effectively reduce the primary CS rate for low-risk NTSV pregnancies without significantly affecting perinatal outcomes. Nature Publishing Group UK 2023-07-11 /pmc/articles/PMC10336068/ /pubmed/37433963 http://dx.doi.org/10.1038/s41746-023-00867-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Cheng, Po Jen
Cheng, You Hung
Shaw, Steven S. W.
Jang, Hung Chi
Reducing primary cesarean delivery rate through implementation of a smart intrapartum surveillance system
title Reducing primary cesarean delivery rate through implementation of a smart intrapartum surveillance system
title_full Reducing primary cesarean delivery rate through implementation of a smart intrapartum surveillance system
title_fullStr Reducing primary cesarean delivery rate through implementation of a smart intrapartum surveillance system
title_full_unstemmed Reducing primary cesarean delivery rate through implementation of a smart intrapartum surveillance system
title_short Reducing primary cesarean delivery rate through implementation of a smart intrapartum surveillance system
title_sort reducing primary cesarean delivery rate through implementation of a smart intrapartum surveillance system
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10336068/
https://www.ncbi.nlm.nih.gov/pubmed/37433963
http://dx.doi.org/10.1038/s41746-023-00867-y
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