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OptiBIRTH: a cluste...
OptiBIRTH: a cluster randomised trial of acomplex intervention to increase vaginalbirth after caesarean section
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- Clarke, Mike (författare)
- Queen’s University Belfast, Belfast, Northern Ireland, UK
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- Devane, Declan (författare)
- National University of Ireland Galway, Galway, Ireland
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- Gross, Mechthild (författare)
- Hannover Medical School, Hannover, Germany
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- Morano, Sandra (författare)
- Universtià degli Studi di Genova, Genoa, Italy
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- Lundgren, Ingela, 1957 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences
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- Sinclair, Marlene (författare)
- Ulster University, Jordanstown, Belfast, Northern Ireland, UK
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- Putman, Koen (författare)
- Department of Public Health, Interuniversity Centre for Health Economics Research (I-CHER), Vrije Universiteit Brussel, Brussels, Belgium
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- Beech, Beverly (författare)
- Association for Improvements in the Maternity Services, Surrey, UK
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- Vehviläinen-Julkunen, Katri (författare)
- University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland
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- Nieuwenhuijze, Marianne (författare)
- Academie Verloskunde Maastricht, Maastricht, the Netherlands
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- Wiseman, Hugh (författare)
- Entando, Belfast, Northern Ireland, UK
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- Smith, Valerie (författare)
- Trinity College Dublin, Dublin, Ireland
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- Daly, Deidre (författare)
- Trinity College Dublin, Dublin, Ireland
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- Savage, Gerard (författare)
- Queen’s University Belfast, Belfast, Northern Ireland, UK
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- Newell, John (författare)
- National University of Ireland Galway, Galway, Ireland
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- Simpkin, Andrew (författare)
- National University of Ireland Galway, Galway, Ireland
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- Grylka-Baeschlin, Susanne (författare)
- Hannover Medical School, Hannover, Germany
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- Healy, Patricia (författare)
- National University of Ireland Galway, Galway, Ireland
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- Nicoletti, Jane (författare)
- Universtià degli Studi di Genova, Genoa, Italy
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- Lalor, Joan (författare)
- Trinity College Dublin, Dublin, Ireland
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- Carroll, Margaret (författare)
- Trinity College Dublin, Dublin, Ireland
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- van Limbeek, Evelien (författare)
- Academie Verloskunde Maastricht, Maastricht, the Netherlands
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- Nilsson, Christina (författare)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd
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- Stockdale, Janine (författare)
- Ulster University, Jordanstown, Belfast, Northern Ireland, UK
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- Fobelets, Maaikke (författare)
- Department of Public Health, Interuniversity Centre for Health Economics Research (I-CHER), Vrije Universiteit Brussel, Brussels, Belgium
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- Begley, Cecily (författare)
- Trinity College Dublin, Dublin, Ireland
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(creator_code:org_t)
- 2020-03-06
- 2020
- Engelska.
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393.
- Relaterad länk:
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https://doi.org/10.1...
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https://bmcpregnancy...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://gup.ub.gu.se...
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Abstract
Ämnesord
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- Background: Despite evidence supporting the safety of vaginal birth after caesarean section (VBAC), rates are lowin many countries.Methods: OptiBIRTH investigated the effects of a woman-centred intervention designed to increase VBAC ratesthrough an unblinded cluster randomised trial in 15 maternity units with VBAC rates < 35% in Germany, Ireland andItaly. Sites were matched in pairs or triplets based on annual birth numbers and VBAC rate, and randomised, 1:1 or 2:1, intervention versus control, following trial registration. The intervention involved evidence-based education ofclinicians and women with one previous caesarean section (CS), appointment of opinion leaders, audit/peer review,and joint discussions by women and clinicians. Control sites provided usual care. Primary outcome was annualhospital-level VBAC rates before the trial (2012) versus final year of the trial (2016). Between April 2014 and October2015, 2002 women were recruited (intervention 1195, control 807), with mode-of-birth data available for 1940women.Results: The OptiBIRTH intervention was feasible and safe across hospital settings in three countries. There was nostatistically significant difference in the change in the proportion of women having a VBAC between interventionsites (25.6% in 2012 to 25.1% in 2016) and control sites (18.3 to 22.3%) (odds ratio adjusted for differences betweenintervention and control groups (2012) and for homogeneity in VBAC rates at sites in the countries: 0.87, 95% CI:0.67, 1.14, p = 0.32 based on 5674 women (2012) and 5284 (2016) with outcome data. Among recruited womenwith birth data, 4/1147 perinatal deaths > 24 weeks gestation occurred in the intervention group (0.34%) and 4/782in the control group (0.51%), and two uterine ruptures (one per group), a rate of 1:1000.Conclusions: Changing clinical practice takes time. As elective repeat CS is the most common reason for CS inmultiparous women, interventions that are feasible and safe and that have been shown to lead to decreasingrepeat CS, should be promoted. Continued research to refine the best way of promoting VBAC is essential. Thismay best be done using an implementation science approach that can modify evidence-based interventions inresponse to changing clinical circumstances.Trial registration: The OptiBIRTH trial was registered on 3/4/2013. Trial registration number ISRCTN10612254.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Annan medicin och hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Other Medical and Health Sciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
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Till lärosätets databas
- Av författaren/redakt...
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Clarke, Mike
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Devane, Declan
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Gross, Mechthild
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Morano, Sandra
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Lundgren, Ingela ...
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Sinclair, Marlen ...
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visa fler...
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Putman, Koen
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Beech, Beverly
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Vehviläinen-Julk ...
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Nieuwenhuijze, M ...
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Wiseman, Hugh
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Smith, Valerie
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Daly, Deidre
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Savage, Gerard
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Newell, John
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Simpkin, Andrew
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Grylka-Baeschlin ...
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Healy, Patricia
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Nicoletti, Jane
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Lalor, Joan
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Carroll, Margare ...
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van Limbeek, Eve ...
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Nilsson, Christi ...
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Stockdale, Janin ...
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Fobelets, Maaikk ...
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Begley, Cecily
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Annan medicin oc ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Reproduktionsmed ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Hälsovetenskap
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och Omvårdnad
- Artiklar i publikationen
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BMC Pregnancy an ...
- Av lärosätet
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Högskolan i Borås
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Göteborgs universitet