• J Eval Clin Pract · Feb 2019

    Defensive caesarean section: A reality and a recommended health care improvement for Romanian obstetrics.

    • Cringu Antoniu Ionescu, Mihai Dimitriu, Elena Poenaru, Mihai Bănacu, Gheorghe Otto Furău, Dan Navolan, and Liana Ples.
    • Department of Obstetrics and Gynecology "St Pantelimon" Clinical Emergency Hospital, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania.
    • J Eval Clin Pract. 2019 Feb 1; 25 (1): 111116111-116.

    RationaleDefensive caesarean section (CS) has become one of the most common medical procedure worldwide. Additionally, performing CS in accordance with the patient's choice is an appropriate professional practice.Aims And ObjectiveThis paper reports a prospective, observational, multicenter study to quantify the use of this type of practice that is performed by obstetricians to avoid medico-legal complaints and decrease the frequency of malpractice litigations.MethodsWe interviewed 73 obstetricians from three distinct units of obstetrics and gynaecology, to assess their opinion regarding defensive caesarean delivery and caesarean delivery performed upon maternal request. We conducted an opinion-based survey using questionnaires based on nine, close-ended questions.ResultsOut of 73 respondents, 51 (69.9%) stated that they perform defensive CS; 63 (86.3%) declared that their choice of birth delivery is influenced by the risk of being accused of malpractice; 60 (82.2%) indicated that it is normal for the patient to be able to decide on the type of delivery; and 63 (86.3%) declared that they consult their patients regarding their delivery preferences. We found statistically significant differences between the respondents who declare that they perform defensive CS (69.9%) and those who said that they are influenced by the risk of malpractice when they choose the method of delivery for their patients (86.3%) (P < .001; McNemar Test).ConclusionsThe results of our study indicate that defensive caesarean section is a widespread practice among obstetrics practitioners in Romania.© 2018 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

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