Correction: Length of stay following vaginal deliveries: A population based study in the Friuli Venezia Giulia region (North-Eastern Italy), 2005-2015 (original) (raw)
Related papers
Scientific Reports, 2020
Although length of stay (LoS) after childbirth has been diminishing in several high-income countries in recent decades, the evidence on the impact of early discharge (ED) on healthy mothers and term newborns after vaginal deliveries (VD) is still inconclusive and little is known on the characteristics of those discharged early. We conducted a population-based study in Friuli Venezia Giulia (FVG) during 2005–2015, to investigate the mean LoS and the percentage of LoS longer than our proposed ED benchmarks following VD: 2 days after spontaneous vaginal deliveries (SVD) and 3 days post instrumental vaginal deliveries (IVD). We employed a multivariable logistic as well as a linear regression model, adjusting for a considerable number of factors pertaining to health-care setting and timeframe, maternal health factors, newborn clinical factors, obstetric history factors, socio-demographic background and present obstetric conditions. Results were expressed as odds ratios (OR) and regressio...
Scientific Reports, 2020
Although there is no evidence that elevated rates of cesarean sections (CS) translate into reduced maternal/child perinatal morbidity or mortality, CS have been increasingly overused almost everywhere, both in high and low-income countries. The primary cesarean section (PCS) has become a major driver of the overall CS (OCS) rate, since it carries intrinsic risk of repeat CS (RCS) in future pregnancies. In our study we examined patterns of PCS, planned PCS (PPCS), vaginal birth after 1 previous CS (VBAC-1) and associated factors in Friuli Venezia Giulia (FVG), a region of North-Eastern Italy, collecting data from its 11 maternity centres (coded from A to K) during 2005–2015. By fitting three multiple logistic regression models (one for each delivery mode), we calculated the adjusted rates of PCS and PPCS among women without history of CS, whilst the calculation of the VBAC rate was restricted to women with just one previous CS (VBAC-1). Results, expressed as odds ratio (OR) with 95% ...
Risk assessment at the end of pregnancy is a poor predictor for complications at delivery
Acta Obstetricia et Gynecologica Scandinavica, 2000
Objective. To evaluate the usefulness of prenatal risk assessment for prediction of need for obstetric interventions. Design. Area based retrospective study. Setting. Västerås Central Hospital, Sweden, with all antenatal care units in the area. Subjects. All women delivered at the only delivery ward in the area, after attending antenatal care at the affiliated ANC-units in 1990 (nΩ2008) and 1992 (nΩ1874). Main outcome measures. Obstetric interventions at delivery. Results. During the two years 81% and 83% of the study population delivered an infant in vertex presentation at term but 15% and 17% without risk factors or complications at the end of pregnancy had complications during delivery. The relative risk for interventions when risk factors were present was 2.2 and with spontaneous onset of labor 1.3/1.4. Low risk primiparae had unforeseen complications in 25% and multiparae in 10%. Relative risk for multiparae with risk factors and spontaneous labor was 2.2/1.8 and for primiparae 1.4/1.6. Conclusions. Individual prediction of obstetric emergencies has low accuracy, which should be included in the information to women as well as in discussions with health planners.
Vaginal birth after caesarean birth in Italy: variations among areas of residence and hospitals
BMC pregnancy and childbirth, 2018
The rates of caesarean section (CS) are increasing globally. CS rates are one of the most frequently used indicators of health care quality. Vaginal Birth After Caesarean (VBAC) could be considered a reasonable and safe option for most women with a previous CS. Despite this fact, in some European countries, many women who had a previous CS will have a routine CS subsequently and VBAC rates are extremely variable across countries. VBAC use is inversely related to caesarean use. The objective of the present study was to analyze VBAC rates with respect to caesarean rates and the variations among areas of residence, hospitals and hospital ownership types in Italy. This study was based on information from the Hospital Information System (HIS). We collected data from all deliveries in Italy from January 1, 2010 to December 31, 2014 and we considered only deliveries with a previous caesarean section. Applying multivariate logistic regression analysis, the adjusted proportions of VBAC for e...
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Background: In spite of the World Health Organization's recommendations to maintain caesarean delivery (CD) between 5% and 15% of total births, the rates of CD continue to rise in countries with routine access to medical services. As in Italy CD rate reached 38% in 2008, the highest at EU level, we evaluated socioeconomic and clinical correlates of ''elective'' and ''non programmed'' CD in the Country. We performed a stratified analysis in order to verify whether the effect of such correlates differed among women with an ''a priori'' preference for natural and caesarean delivery respectively.
The timing of elective caesarean delivery at term in lombardy: a comparison of 2010 and 2014
2016
Elective caesarean section (CS) before 39 completed weeks of gestation increases likelihood of respiratory morbidity in newborns and admissions in neonatal intensive care. Thus, guidelines have recommended that planned caesarean section should not be routinely carried out before 39 completed weeks of gestation. In this paper, we have analyzed the timing of elective CS after 37th completed weeks of gestation in 2010 and 2014 in Lombardy, a region of the North of Italy, in order to evaluate whether there was a measurable change in clinical practice during the last years in the timing of the elective CS. We analyzed data of all deliveries Lombardy, in period of time between 1st January31th December 2010 and 1st January-31th December 2014. From all deliveries, we identified all elective CS deliveries at term.The frequency of elective CS in 37th and 38th week of gestation decreased respectively from 14,2% and 46,7% in 2010 to 13,7% and 44,6% in 2014 (chi square test 37-38 vs 39 or more p...