The effect of the use of a decision aid with individual risk estimation on the mode of delivery after a caesarean section: A prospective cohort study
Autoři:
Emy Vankan aff001; Ellen Schoorel aff001; Sander van Kuijk aff002; Jan Nijhuis aff001; Rosella Hermens aff003; Hubertina Scheepers aff001;
Působiště autorů:
GROW-School for Oncology and Developmental Biology, Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, Maastricht, The Netherlands
aff001; Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Centre+, Maastricht, The Netherlands
aff002; Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
aff003
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222499
Souhrn
Objective
After one previous caesarean section (CS), pregnant women can deliver by elective repeat CS or have a trial of labor which can end in a vaginal birth after caesarean (VBAC) or an unplanned CS. Despite guidelines describing women’s rights to make an informed choice, trial of labor and VBAC rates vary greatly worldwide. Many women are inadequately informed due to caregivers’ fear of an increase in CS rates in a high VBAC rate setting. We compared counseling with a decision aid (DA) including a prediction model on VBAC to care as usual. We hypothesize that counselling with the DA does not decrease VBAC rates. In addition, we aimed to study the effects on unplanned CS rate, patient involvement in decision-making and elective repeat CS rates.
Methods
We performed a prospective cohort study. From 2012 to 2014, 483 women in six hospitals, where the DA was used (intervention group), were compared with 441 women in six matched hospitals (control group). Women with one previous CS, pregnant of a singleton in cephalic presentation, delivering after 37 weeks 0 days were eligible for inclusion.
Results
There was no significant difference in VBAC rates between the intervention (45%) and control group (46%) (adjusted odds ratio 0,92 (95% Confidence interval 0.69–1.23)). In the intervention group more women (42%) chose an elective repeat CS compared to the control group (31%) (adjusted odds ratio 1.6 (95% Confidence interval 1.18–2.17)). Of women choosing trial of labor, in the intervention group 77% delivered vaginally compared to 67% in the control group, resulting in an unplanned CS adjusted odds ratio of 0,57 (0.40–0.82) in the intervention group. In the intervention group, more women reported to be involved in decision-making (98% vs. 68%, P< 0.001).
Conclusions
Implementing a decision aid with a prediction model for risk selection suggests unchanged VBAC rates, but 40% reduction in unplanned CS rates, increase in elective repeat CS and improved patient involvement in decision-making.
Klíčová slova:
Decision making – Hospitals – Intensive care units – Labor and delivery – Neonatal care – Pregnancy – Questionnaires
Zdroje
1. ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol, 2010. 116(2 Pt 1): 450–63. doi: 10.1097/AOG.0b013e3181eeb251 20664418
2. NICE, Caesarean Section, clinical guideline. 2011, London: National Collaborating Centre for Women's and Children's Health.
3. RCOG, Birth after previous caesarean birth. Green-Top Guideline, 2015.
4. Guise JM, Eden K, Emeis C, Denman MA, Marshall N, Fu RR et al. Vaginal birth after cesarean: new insights. Evid Rep Technol Assess (Full Rep), 2010(191): 1–397.
5. MacDorman M, Declercq E, Menacker F, Recent trends and patterns in cesarean and vaginal birth after cesarean (VBAC) deliveries in the United States. Clin Perinatol, 2011. 38(2): 179–92. doi: 10.1016/j.clp.2011.03.007 21645788
6. Martin JA, Hamilton BE, Osterman MJ, Births in the United States, 2015. NCHS Data Brief, 2016(258): 1–8.
7. Kwee A, Bots ML, Visser GH, Bruinse HW, Obstetric management and outcome of pregnancy in women with a history of caesarean section in the Netherlands. Eur J Obstet Gynecol Reprod Biol, 2007. 132(2): 171–6. doi: 10.1016/j.ejogrb.2006.07.017 16904813
8. Melman S., Schoorel EC, de Boer K, Burggraaf H, Derks JB, van Dijk D, et al. Development and Measurement of Guidelines-Based Quality Indicators of Caesarean Section Care in the Netherlands: A RAND-Modified Delphi Procedure and Retrospective Medical Chart Review. PLoS One, 2016. 11(1): e0145771. doi: 10.1371/journal.pone.0145771 26783742
9. McMahon MJ, Luther ER, Bowes WA Jr, Olshan AF, Comparison of a trial of labor with an elective second cesarean section. N Engl J Med, 1996. 335(10): 689–95. doi: 10.1056/NEJM199609053351001 8703167
10. Schoorel EN, van Kuijk SM, Melman S, Nijhuis JG, Smits LJ, Aardenburg R, et al. Vaginal birth after a caesarean section: the development of a Western European population-based prediction model for deliveries at term. BJOG, 2014. 121(2): 194–201; discussion 201. doi: 10.1111/1471-0528.12539 24373593
11. Schoorel EN, Vankan E, Scheepers HC, Augustijn BC, Dirksen CD, de Koning M, et al. Involving women in personalised decision-making on mode of delivery after caesarean section: the development and pilot testing of a patient decision aid. BJOG, 2014. 121(2): 202–9. doi: 10.1111/1471-0528.12516 24373594
12. Vankan E, Schoorel EN, van Kuijk SM, Mol BJ, Nijhuis JG, Aardenburg R, et al. Practice variation of vaginal birth after cesarean and the influence of risk factors at patient level: a retrospective cohort study. Acta Obstet Gynecol Scand, 2016.
13. Kriston L, Scholl I, Holzel L, Simon D, Loh A, Harter M, The 9-item Shared Decision Making Questionnaire (SDM-Q-9). Development and psychometric properties in a primary care sample. Patient Educ Couns, 2010. 80(1): 94–9. doi: 10.1016/j.pec.2009.09.034 19879711
14. Ottawa Health Decision Centre. User manual—decisional conflict scale(s)
15. Montgomery AA, Emmett CL, Fahey T, Jones C, Ricketts I, Patel RR, et al. Two decision aids for mode of delivery among women with previous caesarean section: randomized controlled trial. BMJ 2007;334:1305. doi: 10.1136/bmj.39217.671019.55 17540908
16. Flamm B.L., Geiger A.M., Vaginal birth after cesarean delivery: an admission scoring system. Obstet Gynecol, 1997. 90(6): 907–10. doi: 10.1016/s0029-7844(97)00531-0 9397100
17. Gonen R, Tamir A, Degani S, Ohel G, Variables associated with successful vaginal birth after one cesarean section: a proposed vaginal birth after cesarean section score. Am J Perinatol, 2004. 21(8): 447–53. doi: 10.1055/s-2004-835961 15580540
18. Grobman WA, Lai Y, Landon MB, Spong CY, Leveno KJ, Rouse DJ, et al. Development of a nomogram for prediction of vaginal birth after cesarean delivery. Obstet Gynecol, 2007. 109(4): 806–12. doi: 10.1097/01.AOG.0000259312.36053.02 17400840
19. Grobman WA, Lai Y, Landon MB, Spong CY, Leveno KJ, Rouse DJ et al. Does information available at admission for delivery improve prediction of vaginal birth after cesarean? Am J Perinatol, 2009. 26(10): 693–701. doi: 10.1055/s-0029-1239494 19813165
20. Jakobi P, Weissman A, Peretz BA, Hocherman I, Evaluation of prognostic factors for vaginal delivery after cesarean section. J Reprod Med, 1993. 38(9): 729–33. 8254598
21. Macones GA, Hausman N, Edelstein R, Stamilio DM, Marder SJ, Predicting outcomes of trials of labor in women attempting vaginal birth after cesarean delivery: a comparison of multivariate methods with neural networks. Am J Obstet Gynecol, 2001. 184(3): 409–13. doi: 10.1067/mob.2001.109386 11228495
22. Metz TD, Stoddard GJ, Henry E, Jackson M, Holmgren C, Esplin S, Simple, validated vaginal birth after cesarean delivery prediction model for use at the time of admission. Obstet Gynecol, 2013. 122(3): 571–8. doi: 10.1097/AOG.0b013e31829f8ced 23921867
23. Naji O, Wynants L, Smith A, Abdallah Y, Stalder C, Sayasneh A et al. Predicting successful vaginal birth after Cesarean section using a model based on Cesarean scar features examined by transvaginal sonography. Ultrasound Obstet Gynecol, 2013. 41(6): 672–8. doi: 10.1002/uog.12423 23371440
24. Pickhardt MG, Martin JN Jr., E.F. Meydrech EF, Blake PG, Martin RW, Perry KG Jr et al., Vaginal birth after cesarean delivery: are there useful and valid predictors of success or failure? Am J Obstet Gynecol, 1992. 166(6 Pt 1): 1811–5; discussion 1815–9. 1615990
25. Smith GC, White IR, Pell JP, Dobbie R, Predicting cesarean section and uterine rupture among women attempting vaginal birth after prior cesarean section. PLoS Med, 2005. 2(9): e252. doi: 10.1371/journal.pmed.0020252 16146414
26. Srinivas SK, Stamilio DM, Stevens EJ, Odibo AO, Peipert JF, Macones GA, Predicting failure of a vaginal birth attempt after cesarean delivery. Obstet Gynecol, 2007. 109(4): 800–5. doi: 10.1097/01.AOG.0000259313.46842.71 17400839
27. Tessmer-Tuck JA, El-Nashar SA, Racek AR, Lohse CM, Famuyide AO, Wick MJ, Predicting vaginal birth after cesarean section: a cohort study. Gynecol Obstet Invest, 2014. 77(2): 121–6. doi: 10.1159/000357757 24525697
28. Troyer LR, Parisi VM, Obstetric parameters affecting success in a trial of labor: designation of a scoring system. Am J Obstet Gynecol, 1992. 167(4 Pt 1): 1099–104. doi: 10.1016/s0002-9378(12)80046-9 1415398
29. Weinstein D, Benshushan A, Tanos V, Zilberstein R, Rojansky N, Predictive score for vaginal birth after cesarean section. Am J Obstet Gynecol, 1996. 174(1 Pt 1): 192–8. doi: 10.1016/s0002-9378(96)70393-9 8572005
30. Elwyn G, O'Connor A, Stacey D, Volk R, Edwards A, Coulter A et al., Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ, 2006. 333(7565): 417. doi: 10.1136/bmj.38926.629329.AE 16908462
31. Stacey D, Legare F, Col NF, Bennet CL, Barry MJ, Eden KB et al., Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev, 2014(1): CD001431. doi: 10.1002/14651858.CD001431.pub4 24470076
32. Shorten AB, Shorten B, Keogh J, West S, Morris J, Making choices for childbirth: a randomized controlled trial of a decision-aid for informed birth after cesarean. Birth, 2005. 32(4): 252–61. doi: 10.1111/j.0730-7659.2005.00383.x 16336366
33. Montgomery AA, Emmett CL, Fahey T, Jones C, Ricketts I, Patel RR et al., Two decision aids for mode of delivery among women with previous caesarean section: randomized controlled trial. BMJ, 2007. 334(7607): 1305. doi: 10.1136/bmj.39217.671019.55 17540908
34. Horey D, Kealy M, Davey MA, Small R, Crowther CA, Interventions for supporting pregnant women's decision-making about mode of birth after a caesarean. Cochrane Database Syst Rev, 2013(7): CD010041. doi: 10.1002/14651858.CD010041.pub2 23897547
35. Gardner K, Henry A, Thou S, Davis G, Miller T, Improving VBAC rates: the combined impact of two management strategies. Aust N Z J Obstet Gynaecol, 2014. 54 (4): 327–32. doi: 10.1111/ajo.12229 25117188
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PLOS One
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