Classifications for Cesarean Section: A Systematic Review
Main Author: | |
---|---|
Publication Date: | 2011 |
Other Authors: | , , , , , |
Format: | Article |
Language: | eng |
Source: | Repositório Institucional da UNIFESP |
Download full: | http://repositorio.unifesp.br/handle/11600/33355 http://dx.doi.org/10.1371/journal.pone.0014566 |
Summary: | Background: Rising cesarean section (CS) rates are a major public health concern and cause worldwide debates. To propose and implement effective measures to reduce or increase CS rates where necessary requires an appropriate classification. Despite several existing CS classifications, there has not yet been a systematic review of these. This study aimed to 1) identify the main CS classifications used worldwide, 2) analyze advantages and deficiencies of each system.Methods and Findings: Three electronic databases were searched for classifications published 1968-2008. Two reviewers independently assessed classifications using a form created based on items rated as important by international experts. Seven domains (ease, clarity, mutually exclusive categories, totally inclusive classification, prospective identification of categories, reproducibility, implementability) were assessed and graded. Classifications were tested in 12 hypothetical clinical case-scenarios. From a total of 2948 citations, 60 were selected for full-text evaluation and 27 classifications identified. Indications classifications present important limitations and their overall score ranged from 2-9 (maximum grade = 14). Degree of urgency classifications also had several drawbacks (overall scores 6-9). Woman-based classifications performed best (scores 5-14). Other types of classifications require data not routinely collected and may not be relevant in all settings (scores 3-8).Conclusions: This review and critical appraisal of CS classifications is a methodologically sound contribution to establish the basis for the appropriate monitoring and rational use of CS. Results suggest that women-based classifications in general, and Robson's classification, in particular, would be in the best position to fulfill current international and local needs and that efforts to develop an internationally applicable CS classification would be most appropriately placed in building upon this classification. the use of a single CS classification will facilitate auditing, analyzing and comparing CS rates across different settings and help to create and implement effective strategies specifically targeted to optimize CS rates where necessary. |
id |
UFSP_543d2f327b9e915d68d6b27ae6ff22e0 |
---|---|
oai_identifier_str |
oai:repositorio.unifesp.br:11600/33355 |
network_acronym_str |
UFSP |
network_name_str |
Repositório Institucional da UNIFESP |
repository_id_str |
3465 |
spelling |
Torloni, Maria Regina [UNIFESP]Betran, Ana PilarSouza, Joao PauloWidmer, MarianaAllen, TomasGulmezoglu, MetinMerialdi, MarioUniversidade Federal de São Paulo (UNIFESP)Brazilian Cochrane CtrWorld Hlth Org2016-01-24T14:06:03Z2016-01-24T14:06:03Z2011-01-20Plos One. San Francisco: Public Library Science, v. 6, n. 1, 10 p., 2011.1932-6203http://repositorio.unifesp.br/handle/11600/33355http://dx.doi.org/10.1371/journal.pone.0014566WOS000286522200007.pdf10.1371/journal.pone.0014566WOS:000286522200007Background: Rising cesarean section (CS) rates are a major public health concern and cause worldwide debates. To propose and implement effective measures to reduce or increase CS rates where necessary requires an appropriate classification. Despite several existing CS classifications, there has not yet been a systematic review of these. This study aimed to 1) identify the main CS classifications used worldwide, 2) analyze advantages and deficiencies of each system.Methods and Findings: Three electronic databases were searched for classifications published 1968-2008. Two reviewers independently assessed classifications using a form created based on items rated as important by international experts. Seven domains (ease, clarity, mutually exclusive categories, totally inclusive classification, prospective identification of categories, reproducibility, implementability) were assessed and graded. Classifications were tested in 12 hypothetical clinical case-scenarios. From a total of 2948 citations, 60 were selected for full-text evaluation and 27 classifications identified. Indications classifications present important limitations and their overall score ranged from 2-9 (maximum grade = 14). Degree of urgency classifications also had several drawbacks (overall scores 6-9). Woman-based classifications performed best (scores 5-14). Other types of classifications require data not routinely collected and may not be relevant in all settings (scores 3-8).Conclusions: This review and critical appraisal of CS classifications is a methodologically sound contribution to establish the basis for the appropriate monitoring and rational use of CS. Results suggest that women-based classifications in general, and Robson's classification, in particular, would be in the best position to fulfill current international and local needs and that efforts to develop an internationally applicable CS classification would be most appropriately placed in building upon this classification. the use of a single CS classification will facilitate auditing, analyzing and comparing CS rates across different settings and help to create and implement effective strategies specifically targeted to optimize CS rates where necessary.Universidade Federal de São Paulo, Dept Obstet, São Paulo, BrazilBrazilian Cochrane Ctr, São Paulo, BrazilWorld Hlth Org, Dept Reprod Hlth & Res, Geneva, SwitzerlandWorld Hlth Org, Dept Knowledge Management & Sharing, Geneva, SwitzerlandUniversidade Federal de São Paulo, Dept Obstet, São Paulo, BrazilWeb of Science10engPublic Library SciencePlos OneClassifications for Cesarean Section: A Systematic Reviewinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALWOS000286522200007.pdfapplication/pdf157696${dspace.ui.url}/bitstream/11600/33355/1/WOS000286522200007.pdf62d4329d9df23e74c3b927d662cd1a4fMD51open accessTEXTWOS000286522200007.pdf.txtWOS000286522200007.pdf.txtExtracted texttext/plain57965${dspace.ui.url}/bitstream/11600/33355/2/WOS000286522200007.pdf.txt1d56c4f441a159d5c207f5647a5bfe1fMD52open access11600/333552022-07-08 10:40:18.745open accessoai:repositorio.unifesp.br:11600/33355Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652022-07-08T13:40:18Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Classifications for Cesarean Section: A Systematic Review |
title |
Classifications for Cesarean Section: A Systematic Review |
spellingShingle |
Classifications for Cesarean Section: A Systematic Review Torloni, Maria Regina [UNIFESP] |
title_short |
Classifications for Cesarean Section: A Systematic Review |
title_full |
Classifications for Cesarean Section: A Systematic Review |
title_fullStr |
Classifications for Cesarean Section: A Systematic Review |
title_full_unstemmed |
Classifications for Cesarean Section: A Systematic Review |
title_sort |
Classifications for Cesarean Section: A Systematic Review |
author |
Torloni, Maria Regina [UNIFESP] |
author_facet |
Torloni, Maria Regina [UNIFESP] Betran, Ana Pilar Souza, Joao Paulo Widmer, Mariana Allen, Tomas Gulmezoglu, Metin Merialdi, Mario |
author_role |
author |
author2 |
Betran, Ana Pilar Souza, Joao Paulo Widmer, Mariana Allen, Tomas Gulmezoglu, Metin Merialdi, Mario |
author2_role |
author author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Brazilian Cochrane Ctr World Hlth Org |
dc.contributor.author.fl_str_mv |
Torloni, Maria Regina [UNIFESP] Betran, Ana Pilar Souza, Joao Paulo Widmer, Mariana Allen, Tomas Gulmezoglu, Metin Merialdi, Mario |
description |
Background: Rising cesarean section (CS) rates are a major public health concern and cause worldwide debates. To propose and implement effective measures to reduce or increase CS rates where necessary requires an appropriate classification. Despite several existing CS classifications, there has not yet been a systematic review of these. This study aimed to 1) identify the main CS classifications used worldwide, 2) analyze advantages and deficiencies of each system.Methods and Findings: Three electronic databases were searched for classifications published 1968-2008. Two reviewers independently assessed classifications using a form created based on items rated as important by international experts. Seven domains (ease, clarity, mutually exclusive categories, totally inclusive classification, prospective identification of categories, reproducibility, implementability) were assessed and graded. Classifications were tested in 12 hypothetical clinical case-scenarios. From a total of 2948 citations, 60 were selected for full-text evaluation and 27 classifications identified. Indications classifications present important limitations and their overall score ranged from 2-9 (maximum grade = 14). Degree of urgency classifications also had several drawbacks (overall scores 6-9). Woman-based classifications performed best (scores 5-14). Other types of classifications require data not routinely collected and may not be relevant in all settings (scores 3-8).Conclusions: This review and critical appraisal of CS classifications is a methodologically sound contribution to establish the basis for the appropriate monitoring and rational use of CS. Results suggest that women-based classifications in general, and Robson's classification, in particular, would be in the best position to fulfill current international and local needs and that efforts to develop an internationally applicable CS classification would be most appropriately placed in building upon this classification. the use of a single CS classification will facilitate auditing, analyzing and comparing CS rates across different settings and help to create and implement effective strategies specifically targeted to optimize CS rates where necessary. |
publishDate |
2011 |
dc.date.issued.fl_str_mv |
2011-01-20 |
dc.date.accessioned.fl_str_mv |
2016-01-24T14:06:03Z |
dc.date.available.fl_str_mv |
2016-01-24T14:06:03Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Plos One. San Francisco: Public Library Science, v. 6, n. 1, 10 p., 2011. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/33355 http://dx.doi.org/10.1371/journal.pone.0014566 |
dc.identifier.issn.none.fl_str_mv |
1932-6203 |
dc.identifier.file.none.fl_str_mv |
WOS000286522200007.pdf |
dc.identifier.doi.none.fl_str_mv |
10.1371/journal.pone.0014566 |
dc.identifier.wos.none.fl_str_mv |
WOS:000286522200007 |
identifier_str_mv |
Plos One. San Francisco: Public Library Science, v. 6, n. 1, 10 p., 2011. 1932-6203 WOS000286522200007.pdf 10.1371/journal.pone.0014566 WOS:000286522200007 |
url |
http://repositorio.unifesp.br/handle/11600/33355 http://dx.doi.org/10.1371/journal.pone.0014566 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Plos One |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
10 |
dc.publisher.none.fl_str_mv |
Public Library Science |
publisher.none.fl_str_mv |
Public Library Science |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
bitstream.url.fl_str_mv |
${dspace.ui.url}/bitstream/11600/33355/1/WOS000286522200007.pdf ${dspace.ui.url}/bitstream/11600/33355/2/WOS000286522200007.pdf.txt |
bitstream.checksum.fl_str_mv |
62d4329d9df23e74c3b927d662cd1a4f 1d56c4f441a159d5c207f5647a5bfe1f |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
_version_ |
1802764148775321600 |