Premium
Usefulness of the WHO C‐Model to optimize the cesarean delivery rate in a tertiary hospital setting
Author(s) -
AbdelAleem Hany,
Darwish Atef,
Abdelaleem Ahmad A.,
Mansur Manal
Publication year - 2017
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12092
Subject(s) - medicine , cesarean delivery , tertiary care , tertiary level , obstetrics , emergency medicine , pregnancy , genetics , biology , mathematics education , mathematics
Objective To assess use of the C‐Model in a tertiary hospital setting in terms of its validity and utility for optimizing the cesarean delivery ( CD ) rate. Methods A prospective observational study included women admitted for delivery at a university teaching hospital in Assiut, Egypt, in 2015. The women were asked about the demographic and obstetric information needed to calculate the probability of CD using the WHO C‐Model. A receiver operating characteristic ( ROC ) curve comparing the predicted and observed CD rates was constructed. In addition, the mean predicted CD rates were compared with the mean observed CD rates in the 10 groups of the Robson classification. Results In total, 1000 women were recruited; 38.6% had a previous CD and 13.5% had complications during the current pregnancy. The final mode of delivery was vaginal delivery in 38.7% and CD in 61.3%; the predicted CD rate for this cohort was 45.0%. The area under the ROC curve was 0.928 (95% confidence interval 0.912–0.945). Comparison of the predicted and observed CD rates in the 10 Robson groups showed an overuse of CD ranging from 2% to 50%. Conclusion The WHO C‐Model is valid and can be used in hospital settings to optimize CD rates.