[The impact of a new strict obstetrical strategy on maternal mortality and obstetrical results].
In an attempt to reduce the caesarean section rate without an adverse effect on the obstetrical outcome, new guidelines for the management of dystocia, previous caesarean delivery, fetal distress, and breech presentation were introduced in September 1984 in a provincial hospital in Zimbabwe, Africa. Comparison of the two-year periods before and after September 1984 showed that the caesarean section rate had dropped from 16.8 to 8.0%, the maternal mortality rate from 2.0 to 0.5%, and the perinatal mortality rate from 71.9 to 56.2%. During the latter period use of oxytocin increased from 3.4 to 17.4%. These findings suggest that the adoption of strict guidelines can lead to a decrease of the caesarean section rate and an improvement of the obstetrical outcome in the absence of new technology.
de Muylder
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Thiery
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D000328:Adult; D001946:Breech Presentation; D002585:Cesarean Section; D005260:Female; D005316:Fetal Distress / Q000628:therapy*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008428:Maternal Mortality; D010121:Oxytocin / Q000008:administration & dosage; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011256:Pregnancy Outcome; D015030:Zimbabwe
D010121:Oxytocin
L'impact d'une nouvelle stratégie obstétricale stricte sur la mortalité maternelle et les resultats obstétricaux.