Skip to main content

Advertisement

SpringerLink
Log in

Obstetricians’ perspective towards cesarean section delivery based on professional level: experience from Egypt

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

An Erratum to this article was published on 30 August 2013

Abstract

Objectives

(1) To investigate Egyptian obstetricians’ views towards cesarean delivery on maternal request, (2) to investigate Egyptian obstetricians’ views towards some of the “potentially neglected” or controversial obstetrical skills or maneuvers as external cephalic version (ECV), fetal scalp pH measurement or tubal ligation during CS and (3) to examine the effect of professional level on the above factors.

Study design

This is a descriptive study performed at the 8th annual Obstetrics and Gynecology conference of Suez Canal University held at Ismailia city in Egypt in June 2011 via a structured self administered questionnaire. Questionnaire was distributed to 223 conference attendants from the three professional levels (consultants, specialists and registrars) working at the two major institutions in Egypt: University and Ministry of Health. The structured questionnaire was based on informed opinion and professional guidelines. In total, 167 (75%) completed the questionnaire.

Results

Cesarean delivery on maternal request was accepted by 66% of the studied group and acceptance was significantly higher among consultants. There was no difference in all physicians’ practices of cesarean section in both private and public settings. Limited access to medical equipment such as cardiotocogram (CTG) was shown in consultant group reflecting improper private sector preparations. The study revealed that 59% of obstetricians accepted vaginal breech delivery, and only 14% would consider ECV. Fetal scalp pH taking in cases of abnormal CTG was accepted by only 16.3% and 49% rejected the practice of instrumental delivery. There were significant differences among the three professional and the two institutional groups regarding these attitudes. There were different views regarding tubal sterilization during CS.

Conclusions

Lack of knowledge, the need to improve some clinical skills and some professional attitudes may shed light on rising CS rates in Egypt.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Allen VM, Baskett TF, O’Connell CM (2010) Contribution of select maternal groups to temporal trends in rates of caesarean section. J Obstet Gynaecol Can 32(7):633–641

    PubMed  Google Scholar 

  2. Arikan D, Ozer A, Arikan A, Coskun A, Kiran H (2010) Turkisk obstetricians’ personal preference for mode of delivery and attitude towards cesarean delivery on maternal request. Arch Gynecol Obstet. doi:10.1007/s00404-010-1682-z

  3. Bergholt T, Østerbrg B, Legarth J, Webster T (2004) Danish obstetricians’ personal preference and general attitude to elective cesarean section on maternal request: A national postal survey. Acta Obstet Gynecol Scand 83:262–266

    PubMed  Google Scholar 

  4. Collaris R, Tan PC (2009) Oral nifedipine versus subcutaneous terbutaline tocolysis for external cephalic version: a double-blind randomized trial. BJOG 116(1):74–80 discussion 80–81

    Article  PubMed  CAS  Google Scholar 

  5. El-Zanaty F, Way AA (2009) Egypt Demographic and Health Survey. Cairo, Egypt: Ministry of Health and Population [Arab Republic of Egypt], National Population Council [Arab Republic of Egypt], El-Zanaty and Associates, and ORC Macro

  6. Gabbe GS, Holzman GB (2001) Obstetricians’ choice of delivery. Lancet 357:722

    Article  PubMed  CAS  Google Scholar 

  7. Gedikbasi A, Akyol A, Bingol B, Cakmak D, Sergin A, Uncri R, Caylan Y (2010) Multiple repeated cesarean deliveries: operative complications in the fourth and fifth surgeries in urgent and elective cases. Taiwan J Obstet Gynecol 49(4):425–431

    Article  PubMed  Google Scholar 

  8. Gibbons L, Belizan J, Lauer J, Betran A, Meraldi M, Althabe F (2010) The global number and costs of additionally needed and unnecessary caesarean sections performed per year: over use as a Barrier to Universal Coverage. World Health report, Background paper, No 30. Retrieved from: http://www.who.int/entity/healthsystems/topics/financing/healthreport/30C-sectioncosts.pdf

  9. Guise JM, Eden K, Emeis C, Denmen MA, Marshal N, Fur R, Janik R, Nygren P, Walker M, McDonagh M (2010) Vaginal birth after cesarean: new insights. Evid Rep Technol Assess 191:1–397

    Google Scholar 

  10. Jacquemyna Y, Ahankoura F, Martensb G (2003) Flemish obstetricians’ personal preference regarding mode of delivery and attitude towards caesarean section on demand. Eur J Obstet Gynecol Reprod Biol 111:164–166

    Article  Google Scholar 

  11. Lataifeh I, Zayed F, Al-Kuran O, Al Mehaisen L, Kherisat W, Khadr Y (2009) Jordanian obstetricians’ personal preference regarding mode of delivery. Acta Obstet Gynecol Scand 88(6):733–736

    Article  PubMed  Google Scholar 

  12. Lawrence RE, Rasinski KA, Yoon JD, Curlin FA (2011) Factors influencing physicians’ advice about female sterilization in USA: a national survey. Hum Reprod 26(1):106–111

    Article  PubMed  CAS  Google Scholar 

  13. McCallum C (2005) Explaining caesarean section in Salvador da Bahia, Brazil. Sociol Health Illn 27(2):215–242

    Article  PubMed  Google Scholar 

  14. National Collaborating Centre for Women’s and Children’s Health (2004) Caesarean Section. National Evidence Based Guideline, London

  15. Rauf B, Nisa M, Hassan L (2007) External cephalic version for breech presentation at term. J Coll physicians Surg Pak 17(9):550–553

    PubMed  Google Scholar 

  16. Royal College of Obstetricians and Gynecologists (2004) The use of electronic fetal monitoring: the use and interpretation of cardiotocography in intrapartum fetal monitoring, vol 8, RCOG Press, London (Clinical guideline)

  17. Ryan K, Schnatz P, Greene J, Curry S (2005) Change in caesarean section rate as a reflection of recent malpractices crisis. Conn Med 69:139–141

    PubMed  Google Scholar 

  18. Spetz J, Smith MW, Ennis SF (2001) Physician incentives and the timing of cesarean sections: evidence from California. Med Care 39:536–550

    Article  PubMed  CAS  Google Scholar 

  19. Thomas J, Paranjohy S (2001) The National Sentinel Caesarean Section Audit Report. Royal College of obstetricians and gynecologists: clinical effectiveness support unit. RCOG press, London

Download references

Acknowledgments

This study was financially supported by Ford foundation through the pilot research component of the “PROGRAM OF TRAINING AND RESEARCH IN REPRODUCTIVE HEALTH” implemented by the Social Research Center of the American University in Cairo.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Suez Canal University, Ismailia, Egypt

    Mohamed M. Shaaban & Waleed S. Ahmed

  2. Department of Statistics, Faculty of Economics and Political Sciences and The Social Research Center, The American University in Cairo, Cairo, Egypt

    Zeinab Khadr

  3. Department of Pediatrics, Suez Canal University, Ismailia, Egypt

    Hesham F. El-Sayed

  4. 10 Talaal Saadallah st, Haram Rd, Cairo, Egypt

    Mohamed M. Shaaban

Authors
  1. Mohamed M. Shaaban
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Waleed S. Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zeinab Khadr
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hesham F. El-Sayed
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohamed M. Shaaban.

Additional information

An erratum to this article can be found online at http://dx.doi.org/10.1007/s00404-013-3014-6.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shaaban, M.M., Ahmed, W.S., Khadr, Z. et al. Obstetricians’ perspective towards cesarean section delivery based on professional level: experience from Egypt. Arch Gynecol Obstet 286, 317–323 (2012). https://doi.org/10.1007/s00404-012-2277-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-012-2277-7

Keywords

Search

Navigation