Idoneidad de las indicaciones de cesárea. Una aplicación en la gestión de la práctica clínica

Objectives

To describe the quality management system applied by the Obstetrics and Gynecology Service of the Manacor Hospital, Majorca (Spain) to the process of cesarean section, and to assess the appropriateness of caesarean sections performed in this service between 2004 and 2005.

Subjects and methods

Consensus was reached on evidence-based indications for emergency and elective cesarean sections and on their quality criteria. All clinical records were reviewed to assess the appropriateness of cesarean sections performed from 2004-2005 according to previously established standards.

Results

In all two-monthly periods, appropriateness was achieved according to previously established standards (100% of elective interventions and > 90% of emergency cesarean sections), except in July-August, 2004 and May-June 2005 (appropriateness of elective cesarean sections = 92%), and in July-August 2004 (appropriateness of emergency interventions = 84%).

Conclusions

To reduce unjustified variability in clinical practice, cesarean section indications must be standardized, based on scientific evidence, and regularly assessed.