C-section deliveries down to 1.5% at Delhi’s Safdarjung hospital – ET HealthWorld

New Delhi: The Centre-run Safdarjung Hospital has succeeded in bringing down Caesarean deliveries to 1.5% following the new WHO Labour Care Guide.

The gynaecology department conducted a study on 280 low-risk antenatal (prenatal) women admitted for delivery at this tertiary care institute. It was aimed to determine the effect of the WHO Labour Care Guide on labour outcomes, especially in reducing primary Caesarean deliveries, and its acceptability by healthcare providers.

After excluding women who underwent the Caesarean delivery phase, 136 women in the study group and 135 in the control group were observed. While monitoring was done using the WHO Labour Care Guide in the study group, the WHO modified partograph was considered in the control group. The Caesarean delivery rate was 1.5% in the study group and 17.8% in the control group.

The primary factor for evaluation was mode of delivery, whereas the secondary outcomes were duration of active labour, maternal complications (postpartum hemorrhage and puerperal sepsis, infection of the genital tract occurring at any time between the onset of rupture of membranes or labour), duration of hospital stay, Apgar score at five minutes and neonatal intensive care unit admission.

“Ours is a tertiary care centre with an average annual delivery rate of 28,000. In December 2020, WHO redefined its guidelines for the stages of labour – active and latent. Earlier, we used to consider a 4cm cervical dilatation as the beginning of labour. However, the new guidelines note 5cm cervical dilatation,” said Dr Divya Pandey, professor, gynaecology, Safdarjung Hospital, who conducted the study along with Dr Rekha Bharti, Dr Anjali Dabral and Dr Zeba Khanam.

The duration of the active phase of labour was significantly shorter in the study group than in the control group.

“Now that the small trial has seen success, we are considering taking it to a larger patient population. We are also training residents and nurses under the new guidelines so that more patients can undergo normal delivery. Our aim is to prevent Caesarean delivery,” noted Dr Pandey.

According to the fifth National Family Health Survey, the national C-section rate was 21.5%. WHO has set a benchmark of 10%-15%, which is considered ideal. The number has also gone up since NFHS-4 (conducted in 2015-16), when it was 17.2%.