The Mount Sinai cesarean section reduction program: an update after 6 years.
A six year follow-up evaluation of our original cesarean section reduction program is presented. While establishing obstetric practice guidelines was accomplished, two prerequisites remain critical: lowering cesarean utilization was to be accomplished without harm to mother or fetus, and a target rate was prospectively determined. The results after 6 years indicate that total cesarean rates of 10-12% can consistently be achieved without adverse outcome. Additionally, operative vaginal procedures were employed less that 3% of cases. Separate analysis of 580 breech deliveries failed to show an effect of route of delivery on mortality. This effort indicates that long-term reductions and cesarean utilization are possible with a comprehensive departmental program designed to accomplish achieving a target rate of 11%.
Myers
S A
SA
Department of Obstetrics and Gynecology, Mount Sinai Hospital Medical Center, Chicago, IL 60608.
Gleicher
N
N
D001946:Breech Presentation; D002585:Cesarean Section / Q000706:statistics & numerical data*; D002641:Chicago; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000458:organization & administration*; D006801:Humans; D008429:Maternal Welfare; D009775:Obstetrics and Gynecology Department, Hospital / Q000592:standards*; D016134:Organizational Policy; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D015397:Program Evaluation; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000458:organization & administration*