As the rate of CS continues to rise in Flanders, it is essential to understand the reasons behind this evolution and find ways to achieve appropriate CS rates. For this analysis, we categorized CS changes between 1992 and 2016, applying the TGCS. We also used the TGCS to analyze the only clinics where between 2008 and 2016, the total CS rate had fallen by more than two percent.
The major contributors to that increase were single, cephalic nulliparous women, at term in spontaneous labor; single, cephalic nulliparous women, at a time in induced labor or CS before delivery; and multiparous women with single cephalic at term pregnancy with a history of CS. In the subgroup of the seven clinics where the collective CS rate had decreased from 23.2% in 2008 to 19.3% in 2016, the main contributors to this decrease were Robson groups 1 and 2.
The CS increase in Flanders is mainly the result of the absolute CS increase in the childbirth of nulliparous women with a single cephalic baby in spontaneous or induced labor and women with a single cephalic presentation term and a previous CS. As mentioned earlier, further research in these groups is needed to identify the CS increase’s real reasons.
Reference: https://www.hindawi.com/journals/jp/2020/2793296/
