title: The Dutch obstetric intervention study--variations in practice patterns.
abstract: OBJECTIVE
  To compare obstetric intervention rates between Dutch hospitals.
  
  
  METHODS
  A total of 28,934 hospital births under secondary care (specialist care for medium-/high-risk pregnancies) in 1990 were analyzed in a stratified, random sample of Dutch hospitals based on the records of the Dutch Netherlands perinatal database. Comparisons were made of the intervention rates between hospitals.
  
  
  RESULTS
  The intervention rates of the various hospitals differed widely. The most striking difference was in the cesarean section (CS) rate for non-vertex first twins, with a range of 0-100% and a mean rate of 47.6%. On average a CS for a term breech was performed in 30.8% of cases and sedation or analgesics were administered in 16.2% of cases. The mean rate of episiotomy for a term breech was 71.5%, the lowest rate being 18.8%.
  
  
  CONCLUSIONS
  Our results show relatively low intervention rates with considerable interhospital variation.
authors.affiliation: Department of Obstetrics and Gynecology, University of Amsterdam, Academic Medical Center, The Netherlands.
authors.forename: M H
authors.initials: MH
authors.lastname: Heres
authors.forename: M
authors.initials: M
authors.lastname: Pel
authors.forename: P M
authors.initials: PM
authors.lastname: Elferink-Stinkens
authors.forename: O J
authors.initials: OJ
authors.lastname: Van Hemel
authors.forename: P E
authors.initials: PE
authors.lastname: Treffers
mesh_terms: D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data*; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000706:statistics & numerical data; D009426:Netherlands; D010818:Practice Patterns, Physicians'; D011247:Pregnancy