Features of abdominal delivery in obstetric institutions of level III

Aim. To evaluate and analyse features of abdominal delivery in maternal care institutions (level III) in Krasnodar Krai on the basis of M.S. Robson’ obstetric care criteria (2001) and indicators of cesarean section efficacy.

Materials and methods. A retrospective study of archives from two Krasnodar Krai obstetric institutions (level III) (the perinatal centres of the Children’s Regional Clinical Hospital and the Regional Clinical Hospital No. 2) was carried out. The material for analysis was the number of births, surgery activity and perinatal mortality indicators (2017).

Results. A comparative analysis of abdominal delivery in two leading perinatal centres of the Region revealed low levels of cesarean section efficacy. The monitoring of obstetric conditions, which had the greatest influence on the growth of abdominal delivery cases, was carried out using M.S. Robson’ system. It was revealed that the largest increase in abdominal delivery was observed in patients included in groups I and V.

Conclusion. Despite the fact that the efficacy of abdominal delivery in Krasnodar Krai maternal care institutions (level III) is low, a detailed individualised analysis of indications for the performed surgical labour revealed obstetric practices (uterine scars, fetal distress, anomalies in labour), which increased the level of surgical activity. However, taking into account the specificity of indications for hospitalisation of patients in these medical institutions (severe extragenital pathology, complicated pregnancy), an increase in operative activity and low effectiveness of cesarean section are justified.