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Summary of Results

Health Topic:   Gynaecology, pregnancy and birth
Guidance:   Caesarean section
Description:   The summary of the published clinical guideline on Caesarean section. It links to the published guidance and key documents.

NICE implementation uptake reports

Implementation uptake report Assessment Published Date Coverage

External literature

External literature Assessment Coverage

Towobola, B. (2012) Audit on indication for caesarean section. An International Journal of Obstetrics and Gynaecology. Conference Publication: (var.pagings). 119 (pp 154), 2012. Date of Publication: June 2012.

Description: This study assessed compliance with NICE guidelines on the indication for caesarean section (CS) at Causeway Hospital, Northern Ireland. A retrospective case note audit was carried out on 135 women having CS between July-Dec 2010. Results show emergency CS accounted for 41% while 59% was elective; 4.5% of patients had elective CS based on maternal request alone. Results show that risks and benefits of CS vs vaginal birth were discussed with patients who have had previous CS in only 41% of cases.

Doubts about or mixed impact in practice Local

Yulia, A.et al (2012) Timing of elective caesarean section - Are we deviating from the NICE guideline? An International Journal of Obstetrics and Gynaecology. Conference Publication: (var.pagings). 119 (pp 87), 2012. Date of Publication: June 2012.

Description: This retrospective study aimed to find out the number of elective caesarean section (CS) carried out before 39 weeks gestation by Northumbria NHS Foundation Trust and to find out the number of infant morbidity resulting from variation from NICE guidance. During Jan-Feb 2009 there were 60 elective CS carried out. 15/60 were carried out before 39 weeks gestation: 5/15 had medical reasons; 2/15 had social reasons; 8/15 had no reason recorded. One infant developed transient tachypnea of the newborn.

Practice appears to be in line with guidance Local

Gough, K. L. M. et al (2013) A national survey exploring choice of antibiotic prophylaxis for caesarean section: What impact have the nice guidelines had? International Journal of Obstetric Anesthesia. 2013 Conference (var.pagings) PAGES May-

Description: Results are presented from a national survey, sent electronically to 208 UK lead obstetric anaesthetists, which examined awareness of the updated NICE guideline for caesarean section and impact of the guideline on choice of antibiotic for caesarean section. 148 responses were received (72.2%). Results show 93.4% of respondents were aware of the updated recommendations for antibiotic choice, and 52% of units have changed the antibiotic choice since publication of the guideline.

Doubts about or mixed impact in practice National

Portch, D.J. et al (2012) A survey of antibiotic prophylaxis for caesarean section in South-West England. Anaesthesia. Conference Publication: (var.pagings). 67 (pp 64), 2012. Date of Publication: October 2012.

Description: The aim of this study was to identify current and future practice of the administration of prophylactic antibiotics for caesarean section in South-West England. An online survey was distributed to members of the regional obstetric anaesthetic group and anaesthetic departments at each institution in the region, from which there were 74 responses. Results showed 2 out of 9 obstetric anaesthetic consultants still administered antibiotics after delivery and 7 still used co-amoxiclav.

Practice appears not to be in line with guidance Local

Lou, Y. Y. et al (2013) Caesarean section on maternal request: How well did we do? BJOG: An International Journal of Obstetrics and Gynaecology. 2013 Conference (var.pagings) PAGES June -

Description: This prospective audit was carried out to assess current practice in caesarean section (CS) on maternal request against guidelines. Data were collected from 53 case notes of women who had caesarean section between January and June 2012 at Tunbridge Wells Hospital. Results found 79.2% of the patients had documentation of counselling regarding risks and benefits of CS versus vaginal delivery. However, there was no documentation of discussion regarding future pregnancies of fertility.

Doubts about or mixed impact in practice Local

Mackenzie, C. et al (2013) Decision to delivery time, fetal acidosis and the 30 min rule for grade one caesarean sections; a retrospective study BJOG: An International Journal of Obstetrics and Gynaecology. 2013 Conference (var.pagings) PAGES June -

Description: This study measured how many grade 1 caesarean sections were performed within 30 minutes from the decision to deliver being made. Retrospective data were collected on 150 consecutive grade 1 caesarean sections perfumed in a tertiary referral hospital. Results found 62.4% women had a decision to delivery interval of 30 minutes or less and 99.3% of under 75 minutes.

Doubts about or mixed impact in practice Local

Sawati, A. T. et al (2013) An audit into the use of prophylactic antibiotics during caesarean section at a central teaching hospital: Are national guidelines being followed? BJOG: An International Journal of Obstetrics and Gynaecology. 2013 Conference (var.pagings) PAGES June -

Description: This prospective audit aimed to determine whether the use of antibiotics during caesarean section is in accordance with guidelines. Data were collected on 65 caesarean sections performed at Southern General Hospital, Glasgow between May and June 2012. Results found that all 65 patients were given prophylactic antibiotics after skin incision and in 59/65 (91%) patients just Co-amoxiclav was used.

Practice appears not to be in line with guidance Local

Win, S. et al (2013) Audit of wound infection after caesarean section BJOG: An International Journal of Obstetrics and Gynaecology. 2013 Conference (var.pagings) PAGES June -

Description: This retrospective audit aimed to determine compliance with guidelines on surgical site infection following lower segment caesarean section (LSCS) at the Great Western Hospital, Swindon. Data were collected February ? March 2011, results included: there was no information on pre-operative showering in patient information leaflet for LSCS; prophylactic antibiotics was given to all to all LCSC cases but after delivery of baby; and hair removal was by clippers with a disposable head in all cases.

Practice appears not to be in line with guidance Local

Royal College of Obstetricians and Gynaecologists (2012) Patterns of Maternity Care in English NHS Hospitals 2011/12

Description: This report describes progress made towards development of a repository of clinical maternity data to enable fair comparisons of maternity services. Hospital Episode Statistics (HES) data is presented for April 2011 to March 2012 for a sample of 644,248 deliveries by women aged 15-45 in English NHS hospitals. Among 147/164 hospitals with good data quality, the mean rate of elective caesarean section before 39 weeks of gestation was 30.3%. Hospital-level rates ranged between 5.8 and 58.2%.

Doubts about or mixed impact in practice National

This page was last updated: 01 June 2013

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.