Portal de Periódicos da CAPES

FIGO position paper: how to stop the caesarean section epidemic

2018; Elsevier BV; Volume: 392; Issue: 10155 Linguagem: Inglês

10.1016/s0140-6736(18)32113-5

1474-547X

Gerard H.A. Visser, Diogo Ayres‐de‐Campos, Eytan R. Barnea, Luc de Bernis, Gian Carlo Di Renzo, María Fernanda Escobar Vidarte, Isabel Lloyd, Anwar H. Nassar, Wanda K. Nicholson, P K Shah, William Stones, Luming Sun, Gerhard Theron, Salimah R. Walani,

Global Maternal and Child Health

Worldwide there is an alarming increase in caesarean section (CS) rates. The medical profession on its own cannot reverse this trend. Joint actions with governmental bodies, the health-care insurance industry, and women's groups are urgently needed to stop unnecessary CSs and enable women and families to be confident of receiving the most appropriate obstetric care for their individual circumstances. Global epidemiology of use of and disparities in caesarean sectionsIn this Series paper, we describe the frequency of, trends in, determinants of, and inequalities in caesarean section (CS) use, globally, regionally, and in selected countries. On the basis of data from 169 countries that include 98·4% of the world's births, we estimate that 29·7 million (21·1%, 95% uncertainty interval 19·9–22·4) births occurred through CS in 2015, which was almost double the number of births by this method in 2000 (16·0 million [12·1%, 10·9–13·3] births). CS use in 2015 was up to ten times more frequent in the Latin America and Caribbean region, where it was used in 44·3% (41·3–47·4) of births, than in the west and central Africa region, where it was used in 4·1% (3·6–4·6) of births. Full-Text PDF Short-term and long-term effects of caesarean section on the health of women and childrenA caesarean section (CS) can be a life-saving intervention when medically indicated, but this procedure can also lead to short-term and long-term health effects for women and children. Given the increasing use of CS, particularly without medical indication, an increased understanding of its health effects on women and children has become crucial, which we discuss in this Series paper. The prevalence of maternal mortality and maternal morbidity is higher after CS than after vaginal birth. CS is associated with an increased risk of uterine rupture, abnormal placentation, ectopic pregnancy, stillbirth, and preterm birth, and these risks increase in a dose–response manner. Full-Text PDF Interventions to reduce unnecessary caesarean sections in healthy women and babiesOptimising the use of caesarean section (CS) is of global concern. Underuse leads to maternal and perinatal mortality and morbidity. Conversely, overuse of CS has not shown benefits and can create harm. Worldwide, the frequency of CS continues to increase, and interventions to reduce unnecessary CSs have shown little success. Identifying the underlying factors for the continuing increase in CS use could improve the efficacy of interventions. In this Series paper, we describe the factors for CS use that are associated with women, families, health professionals, and health-care organisations and systems, and we examine behavioural, psychosocial, health system, and financial factors. Full-Text PDF