Trends in Institutional Caesarean Delivery among Low-Risk Patients in Senegal and Mali: Secondary Analysis of a Cluster-Randomized Trial (Quarite)

摘要: Objective: To measure the trends of institutional caesarean rates in Senegal and Mali to assess if these were modified by Advances Labour Risk Management (ALARM) international program. Methods: We conducted a secondary analysis QUARITE trial examine delivery among low-risk patients 46 hospitals which randomized into an intervention group (n = 23) control 23). ALARM combined maternal death reviews continuous medical education improve quality obstetric care. Results: Between pre-intervention period post-intervention period, rate increased from 17.1% 18.6% (adjusted OR=1.03; 95% CI =0.89-1.15) 16.1% 21.1% arm OR=1.47; CI=1.27-1.52). The increase was significantly higher than group, p<0.0001. Conclusion: Caesarean referral after free policy implemented. Because potential arms for mothers newborns associated with unnecessary delivery, program should be considered as promising limit excessive rise caesareans this context.