A survey on the current practice of indicating an elective cesarean after a previous myomectomy

Autor: Giovanni Delli Carpini, Valeria Verdecchia, Luca Giannella, Jacopo Di Giuseppe, Barbara Gardella, Pantaleo Greco, Ettore Cicinelli, Andrea Ciavattini
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Annals of Medicine, Vol 55, Iss 1 (2023)
Druh dokumentu: article
ISSN: 07853890
1365-2060
0785-3890
DOI: 10.1080/07853890.2023.2197292
Popis: AbstractObjective The objective of this study was to evaluate the attitude of obstetricians/gynecologists toward indicating an elective cesarean delivery in pregnant patients with a previous myomectomy.Materials and Methods Web-based multiple-choice questions survey evaluating the attitude to indicate a cesarean with a composite summated score (range 56–280) from a 56-item Likert scale: score 56–112: weak attitude, 113–168: moderate, 169–224: strong, and 225–280: very strong. The reliability of the score (internal consistency) was evaluated with Cronbach’s alpha coefficient. The association between the score and participants’ characteristics was determined with a bivariate analysis followed by linear regression analysis. The “global importance” of each risk factor was defined as the prevalence of the answers: “moderately important”, “very important”, and “extremely important” on the Likert scale. Factors with a “global importance” >75% were considered “crucial” in influencing the choice to indicate a cesarean.Results One-hundred-twenty obstetricians/gynecologists responded (response rate 70.6%). The mean ± SD composite summated score was 137 ± 31; 30 (25.0%) participants presented a "weak attitude to cesarean", 68 (56.7%) a "moderate attitude", 22 (18.3%) a "strong attitude", and none a "very strong attitude". The Cronbach’s alpha was 0.934 (high internal consistency). A self-reported number of myomectomies performed per year >50 was associated with a lower score (-25 points, 95% CI −50 to −1, p = 0.04). Eight criteria resulted “crucial” in indicating a cesarean: opening of the endometrial cavity, monopolar electrosurgery, time surgery-pregnancy
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