Reducing Caesarean Rates in Qatar: A Pressing Public Health Imperative – Policy adjustments in Labour Inductions.

<h3>Background</h3><p dir="ltr">Caesarean rates have doubled in 15 years, increasing 4% annually with disastrous public health consequences from associated maternal and perinatal morbidity and mortality. A policy adjustment favouring second cycle Prostaglandin inductions...

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Main Author: Morounfolu Thompson (17045472) (author)
Other Authors: Manal Moghrabi (18507623) (author), Yehia Elkhawly (17039088) (author), Amna Tellisi (18507624) (author), Ayman Hamsho (18507625) (author), Yasmeen Kayani (17039097) (author), Kholode Al Maslamani (18507539) (author), Lolwa Al Ansari (18466227) (author)
Published: 2024
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_version_ 1864513515096637440
author Morounfolu Thompson (17045472)
author2 Manal Moghrabi (18507623)
Yehia Elkhawly (17039088)
Amna Tellisi (18507624)
Ayman Hamsho (18507625)
Yasmeen Kayani (17039097)
Kholode Al Maslamani (18507539)
Lolwa Al Ansari (18466227)
author2_role author
author
author
author
author
author
author
author_facet Morounfolu Thompson (17045472)
Manal Moghrabi (18507623)
Yehia Elkhawly (17039088)
Amna Tellisi (18507624)
Ayman Hamsho (18507625)
Yasmeen Kayani (17039097)
Kholode Al Maslamani (18507539)
Lolwa Al Ansari (18466227)
author_role author
dc.creator.none.fl_str_mv Morounfolu Thompson (17045472)
Manal Moghrabi (18507623)
Yehia Elkhawly (17039088)
Amna Tellisi (18507624)
Ayman Hamsho (18507625)
Yasmeen Kayani (17039097)
Kholode Al Maslamani (18507539)
Lolwa Al Ansari (18466227)
dc.date.none.fl_str_mv 2024-05-26T06:03:56Z
dc.identifier.none.fl_str_mv 10.57945/manara.25709355.v1
dc.relation.none.fl_str_mv https://figshare.com/articles/conference_contribution/Reducing_Caesarean_Rates_in_Qatar_A_Pressing_Public_Health_Imperative_Policy_adjustments_in_Labour_Inductions_/25709355
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Reproductive medicine
Labour
Induction
Caesarean
Prostaglandin
Audit
Qatar Health Congress 2023 and the 3rd Qatar Public Health Conference
dc.title.none.fl_str_mv Reducing Caesarean Rates in Qatar: A Pressing Public Health Imperative – Policy adjustments in Labour Inductions.
dc.type.none.fl_str_mv Text
Conference contribution
info:eu-repo/semantics/publishedVersion
text
conference object
description <h3>Background</h3><p dir="ltr">Caesarean rates have doubled in 15 years, increasing 4% annually with disastrous public health consequences from associated maternal and perinatal morbidity and mortality. A policy adjustment favouring second cycle Prostaglandin inductions could reduce these rates. Although research studies support this proposal, efficacy and safety data are limited. A review of the efficacy and safety of Prostaglandin induction between 2020-2022 was proposed. </p><h3>Methods</h3><p dir="ltr">An electronic patient record review of Al Wakra Hospital labour inductions, maternal and perinatal outcomes in women who required a second cycle of Prostaglandin induction was conducted. Outcome data obtained in this cohort included parity, successful labour induction, mode of delivery, and significant maternal and neonatal morbidity. </p><h3>Results</h3><p dir="ltr">There were 1,707 labour inductions during the two-year audit period, 790 were Prostaglandin inductions, 100 requiring a second induction cycle. Among primiparae, 44% had a vaginal delivery while 56% had a Caesarean section. 75% of multiparae had a vaginal delivery with 25% needing Caesarean section. The risk of Caesarean was higher among primiparae compared to multiparae (Figure 1). Postpartum haemorrhage occurred in 12 %, and postpartum pyrexia in 28%, 13% of whom had a positive blood culture result to various organisms. Notably, 87% of newborns had a 5-minute Apgar ≥ 9, and no cases were reported with a 5-minute Apgar score below 7. Maternal and neonatal morbidity did not increase compared to baseline unit data, and 50% of the women achieved a vaginal delivery, reducing the number of Caesarean sections.</p><h3>Conclusion</h3><p dir="ltr">The use of a second cycle of vaginal Prostaglandin E2 (PGE2 ) for induction of labour was effective and safe as reflected by the absence of birth asphyxia, and low rates of comparable times to delivery without significant complications (Figure 2). Randomized controlled trials are needed to identify ideal dosage regimens from a clinical and cost?effectiveness perspective.</p>
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id Manara2_bfadaccaed3ea55bc467b42aa9c0d831
identifier_str_mv 10.57945/manara.25709355.v1
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/25709355
publishDate 2024
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spelling Reducing Caesarean Rates in Qatar: A Pressing Public Health Imperative – Policy adjustments in Labour Inductions.Morounfolu Thompson (17045472)Manal Moghrabi (18507623)Yehia Elkhawly (17039088)Amna Tellisi (18507624)Ayman Hamsho (18507625)Yasmeen Kayani (17039097)Kholode Al Maslamani (18507539)Lolwa Al Ansari (18466227)Biomedical and clinical sciencesClinical sciencesReproductive medicineLabourInductionCaesareanProstaglandinAuditQatar Health Congress 2023 and the 3rd Qatar Public Health Conference<h3>Background</h3><p dir="ltr">Caesarean rates have doubled in 15 years, increasing 4% annually with disastrous public health consequences from associated maternal and perinatal morbidity and mortality. A policy adjustment favouring second cycle Prostaglandin inductions could reduce these rates. Although research studies support this proposal, efficacy and safety data are limited. A review of the efficacy and safety of Prostaglandin induction between 2020-2022 was proposed. </p><h3>Methods</h3><p dir="ltr">An electronic patient record review of Al Wakra Hospital labour inductions, maternal and perinatal outcomes in women who required a second cycle of Prostaglandin induction was conducted. Outcome data obtained in this cohort included parity, successful labour induction, mode of delivery, and significant maternal and neonatal morbidity. </p><h3>Results</h3><p dir="ltr">There were 1,707 labour inductions during the two-year audit period, 790 were Prostaglandin inductions, 100 requiring a second induction cycle. Among primiparae, 44% had a vaginal delivery while 56% had a Caesarean section. 75% of multiparae had a vaginal delivery with 25% needing Caesarean section. The risk of Caesarean was higher among primiparae compared to multiparae (Figure 1). Postpartum haemorrhage occurred in 12 %, and postpartum pyrexia in 28%, 13% of whom had a positive blood culture result to various organisms. Notably, 87% of newborns had a 5-minute Apgar ≥ 9, and no cases were reported with a 5-minute Apgar score below 7. Maternal and neonatal morbidity did not increase compared to baseline unit data, and 50% of the women achieved a vaginal delivery, reducing the number of Caesarean sections.</p><h3>Conclusion</h3><p dir="ltr">The use of a second cycle of vaginal Prostaglandin E2 (PGE2 ) for induction of labour was effective and safe as reflected by the absence of birth asphyxia, and low rates of comparable times to delivery without significant complications (Figure 2). Randomized controlled trials are needed to identify ideal dosage regimens from a clinical and cost?effectiveness perspective.</p>2024-05-26T06:03:56ZTextConference contributioninfo:eu-repo/semantics/publishedVersiontextconference object10.57945/manara.25709355.v1https://figshare.com/articles/conference_contribution/Reducing_Caesarean_Rates_in_Qatar_A_Pressing_Public_Health_Imperative_Policy_adjustments_in_Labour_Inductions_/25709355CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/257093552024-05-26T06:03:56Z
spellingShingle Reducing Caesarean Rates in Qatar: A Pressing Public Health Imperative – Policy adjustments in Labour Inductions.
Morounfolu Thompson (17045472)
Biomedical and clinical sciences
Clinical sciences
Reproductive medicine
Labour
Induction
Caesarean
Prostaglandin
Audit
Qatar Health Congress 2023 and the 3rd Qatar Public Health Conference
status_str publishedVersion
title Reducing Caesarean Rates in Qatar: A Pressing Public Health Imperative – Policy adjustments in Labour Inductions.
title_full Reducing Caesarean Rates in Qatar: A Pressing Public Health Imperative – Policy adjustments in Labour Inductions.
title_fullStr Reducing Caesarean Rates in Qatar: A Pressing Public Health Imperative – Policy adjustments in Labour Inductions.
title_full_unstemmed Reducing Caesarean Rates in Qatar: A Pressing Public Health Imperative – Policy adjustments in Labour Inductions.
title_short Reducing Caesarean Rates in Qatar: A Pressing Public Health Imperative – Policy adjustments in Labour Inductions.
title_sort Reducing Caesarean Rates in Qatar: A Pressing Public Health Imperative – Policy adjustments in Labour Inductions.
topic Biomedical and clinical sciences
Clinical sciences
Reproductive medicine
Labour
Induction
Caesarean
Prostaglandin
Audit
Qatar Health Congress 2023 and the 3rd Qatar Public Health Conference