Factors affecting the obstetrician decision on the route of delivery in high risk pregnancies

الملخص EN

Objective: To determine factors which affect the obstetricians decision on the route of delivery in the high-risk pregnancies.

Methods: This study was conducted during the period from 1 January 1998 to 31 December 1998 at four military hospitals.

Comparison was made between two groups of hospitals.

Group I comprised Prince Rashed and Prince Hashim Hospitals and group II comprised Prince Zaid and Princess Haya Hospitals.

The number and reasons for cesarean section were analyzed.

A designed questionnaire regarding labor management in high-risk pregnancies, hospital facilities and obstetrician characteristics was used.

Results: Cesarean section rates ranged from 8.5% to 8.6% in group I compared with 10.5% to 11.8% in group II.

A statistically significant difference in cesarean section rate between both groups was observed (p<0.05).

There were no patients and fetal demographic differences between the two hospital groups, while significant physician and hospital demographic differences were noted.

No significant difference in the neonatal outcome with the different cesarean section rates was observed.

Conclusion: The high cesarean section rate is not necessarily a manifestation of poor decision-making.

Obstetrician’s age, experience and practice settings play an important role in cesarean section decision.