title: [Introducing a daily obstetric audit: A solution to reduce the cesarean section rate?].
abstract: OBJECTIVE
  To evaluate the impact of a medical audit assessing the accuracy of caesarean indications on the final caesarean section rate of an obstetrics department.
  
  
  METHODS
  Comparative observational study conducted in a regional university teaching hospital on the two first quadrimester periods of 2013. During the first quadrimester, there was no cesarean section audit introduced for the daily reports meetings, while an audit was introduced during the second quadrimester. The caesarean rate and the instrumental delivery rate on both quadrimesters were compared.
  
  
  RESULTS
  In the first quadrimester period, there were 248 caesarean sections for 947 deliveries (26.2%), while in the second quadrimester period, there were 246 for 1033 deliveries (23.8%), P=0.014. The emergency caesarean rate decreased from 19.6 to 16.7%, P=0.02 in the second quadrimester period while the instrumental delivery rate increased from 14.4 to 17.2%, P=0.0004. Mothers and children's health was not modified between the two periods.
  
  
  CONCLUSIONS
  In our experience, the introduction of a daily obstetric audit of the caesarean indications is effective to decrease the emergency caesarean section rate and it encourages us to be active in the first like in the second part of the labor.
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, C.S. 10217, 38043 Grenoble cedex 09, France.
authors.forename: A
authors.initials: A
authors.lastname: Lasnet
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, C.S. 10217, 38043 Grenoble cedex 09, France.
authors.forename: A-F
authors.initials: AF
authors.lastname: Jelen
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, C.S. 10217, 38043 Grenoble cedex 09, France; Université Joseph-Fourier, B.P. 53, 38041 Grenoble cedex 09, France.
authors.forename: X
authors.initials: X
authors.lastname: Douysset
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, C.S. 10217, 38043 Grenoble cedex 09, France; Université Joseph-Fourier, B.P. 53, 38041 Grenoble cedex 09, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Pons
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Grenoble, C.S. 10217, 38043 Grenoble cedex 09, France; Université Joseph-Fourier, B.P. 53, 38041 Grenoble cedex 09, France. Electronic address: fsergent@chu-grenoble.fr.
authors.forename: F
authors.initials: F
authors.lastname: Sergent
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008485:Medical Audit / Q000592:standards / Q000706:statistics & numerical data*; D009775:Obstetrics and Gynecology Department, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D011247:Pregnancy
keywords: Audit obstétrical; Caesarean section rate; Classification; Extraction instrumentale; Instrumental delivery; Labor; Obstetric audit; Taux de césarienne; Travail