A pilot randomised controlled trial (RCT) to assess the effect of antenatal counselling sessions on vbac rates
| Autor: | SL Cunningham, M Steen, C Emmett, CL Mather |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Pediatrics
medicine.medical_specialty business.industry Vaginal birth Obstetrics Previous pregnancy medicine.medical_treatment Obstetrics and Gynecology General Medicine Intervention group law.invention Primary outcome Randomized controlled trial Standard care law Pediatrics Perinatology and Child Health medicine Caesarean section business |
| Zdroj: | Archives of Disease in Childhood - Fetal and Neonatal Edition. 97:A94.1-A94 |
| ISSN: | 1468-2052 1359-2998 |
| DOI: | 10.1136/fetalneonatal-2012-301809.305 |
| Popis: | Background The national Caesarean Section (CS) rate in the UK is almost 25%, having increased by 5.7% in the last 10 years; primary CS is a significant contributory. There are two standard care pathways following primary CS; Vaginal Birth After Caesarean (VBAC) or Elective Repeat CS (ERCS). Currently 70.8% of women who have experienced a primary CS will choose ERCS despite evidence supporting VBAC. Aim to identify if focused ante-natal counselling sessions impact upon pathway choice. Method A pilot two-armed RCT was undertaken. Pregnant women who had experienced a primary lower segment CS in the previous pregnancy were recruited, consented, and electronically randomised. Participants in the intervention group attended two ante-natal counselling appointments with the research midwife; the control group followed the Trusts routine ante-natal pathway. Primary outcome was the woman9s choice of VBAC versus ERCS. Postnatally both groups completed a questionnaire. Results 49 invitations were posted to potential participants. 18 women responded and 12 agreed to be randomised. There were 8 participants in the intervention group and 4 in the control. Antenatally, 87.5% (n=7) from the intervention group chose VBAC, compared to 75% (n=3) in the control. However, as a result of intrapartum events and obstetric guidance only 50% in each group delivered by VBAC. Conclusion Focused antenatal counselling sessions advocating VBAC may impact upon the pathway a woman chooses; they may also contribute by supporting her throughout the antenatal and intrapartum periods. However, the impact of intrapartum events and obstetric guidance affects a woman9s capacity to deliver by VBAC. |
| Databáze: | OpenAIRE |
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