Peculiarities of Abdominal Delivery of Preterm Labor in the 3rd Level Hospital in Dushanbe City

Abstract

Study Objective: To assess the impact of caesarean section rate on perinatal outcomes of preterm birth (PB) in a level 3 hospital based on the caesarean section efficiency ratio. Study Design: Retrospective group study. Materials and Мethods. An analysis was made of the PB histories of women delivered by caesarean section in 2021 at the State Institution “Scientific Research Institute of Obstetrics, Gynecology and Perinatology” of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan, as well as data from annual reports for the city of Dushanbe and for the institution. Study Results. In a level 3 hospital, every third delivery is by caesarean section. It has been shown that the proportion of perinatal mortality (PM) in PD is 5.5 times higher than in urgent delivery: 84.6 vs. 15.4%. In extremely early PD (EEPB) by caesarean section, the proportion of PM was statistically significantly higher than the proportion of neonatal survival: 95 ± 4.9% vs. 5 ± 4.9% (р < 0,001). The efficiency ratio of caesarean section in the 3rd level hospital is low (0.3) due to the high relative contribution of caesarean sections for EEPD and EPB to the total number of cesarean sections and the prevalence of PM over neonatal survival for EEPB and EPB. Conclusion. The search for reserves to reduce the frequency of caesarean section in group 10 on the М. Robson scale should be carried out among patients with EEPB and EPB. Keywords: preterm birth, caesarean section, Robson score, caesarean section efficiency ratio.