آيا مي توان ميزان سزارين را در استان مازندران كاهش داد؟

Can the cesarean rate be reduced in Mazandaran

Background and purpose : Considerable controversy exists about the appropriate rate of cesarean deliveries. Cesarean section is a major surgery and is more hazardous to the mother and fetus than vaginal delivery. In Iran in 2002, 36% and in the Mazandaran province 56% of all deliveries were made by cesarean section. This study proposes to determine the effect of statewide policies on cesarean delivery rate in two hospitals of Mazandaran. Materials and methods : This study was a clinical trial research and performed in two hospitals of Mazandaran province between the years 2002 (November) and 2003 (September). Letters were sent to each obstetrician to Inform her about proportion of conducted cesarean by herself and its differece with the world standards in case hospital at June 2003. Data collection continued during this time and last until September 2003 in two hospitals.Then data compaired before and after intervention and analyzed with descriptive (Frequerey, Mean, SD, Table) & analytical (X2, Compare mean) statistical methods. Results : During the study period, 2171 deliveries in case hospital and 980 deliveries in control hospital were made of which 44.8% and 46.6% were cesarean in case and contral hospitals respectively. Statistical analysis showed that hospital policies have no effect on cesarean delivery rate. Before and after the intervension in both hospitals the main indication of cesarean was cesarean repeat. Conclusion : Regarding the results of this study and the statewide policies, it is suggested that more supervisions on cesarean rate are necessary and vaginal birth after cesarean should be encouraged.