Clinical trial NCT02785094: Education and Social Media Versus Non-Indicated Caesarean Section Rate in Egypt
Official title: Education and Social Media Versus Non-Indicated Caesarean Section Rate in Egypt
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Complications; Cesarean Section
Keywords: Caesarean Section Rate
Primigravida
Lead sponsor: Talkha Central Hospital
Sponsor class: OTHER_GOV
First posted: 2016-05-27
Enrollment: 1400
Sex: FEMALE
Minimum age (years): 20
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Primigravidas whom been carefully counselled, and the overall risks and benefits of caesarean section and vaginal birth, and IOL for prolonged pregnancy discussed with.

Brief summary: This study focus on measuring effect of Egyptian Primigravidas' education level and accessibility to social media on rate of maternal request option offered for non-indicated primary caesarean section.

Detailed description: A caesarean section (CS) is a life-saving surgical procedure when certain complications arise during pregnancy and labour. However, it is a major surgery and is associated with immediate maternal and perinatal risks and may have implications for future pregnancies as well as long-term effects that are still being investigated. The use of CS has increased dramatically worldwide in the last decades particularly in middle- and high-income countries, and some studies showing a link between increasing CS rates and poorer outcomes, and reasons for this increase are multifactorial and not well-understood.

In Egypt the CS rate according to WHO (World Health Organization),Health report (2010) is 27.6 %. Egypt also is considered to be the highest African country in CS rate (51.8 %), in which CS rate rose from 4.6 % to 51.8 % over the 24 year period (1990-2014), and more than half of all women give birth by CS in Egypt without much difference between urban and rural areas.

Slightly more than half of the live births in the five-year period before 2014 Egypt Demographic and Health survey were by CS, and 60 % of primigravidas delivered by CS.

Updated indications of primary CS including option of maternal request as one of these indications were reported in both RCOG (Royal College of Obstetricians and Gynaecologists) Press report (2001) and RCOG CS various guidelines.

Recently, the Egyptian public opinion deviated to obstetricians' desire for self financial benefits to be the major cause of increasing Egypt CS rates; depending on newspaper articles and social media talks.

Eligibility criteria: Inclusion Criteria:

* Full term with gestational age (G.A) more than or equal 39 weeks.
* Acceptance to answer study short questionnaire to determine eligible participants for each cohort.

Exclusion Criteria:

* Multiparity.
* History of previous Caesarean Section/s.
* Any Mental or Physical disabilities.
* Disapproval for answering a predefined short questionnaire related to study.

Primary outcomes:
measure: Number of Primigravidas who request a Non-Indicated CS
timeFrame: Up to 2 weeks
Secondary outcomes:
measure: Number of Primigravidas who refused to have a trial of IOL (Induction of Labour), as an index for deviated intention to request a Non-Indicated CS
timeFrame: Up to 24 hours
Other outcomes:
Locations:
city: Mansoura
country: Egypt
facility: Talkha Central Hospital
state: Al-Dakahliya
Study officials:
affiliation: Talkha Central Hospital
name: Amro M Hetta, M.B., Ch.B.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Betran AP, Ye J, Moller AB, Zhang J, Gulmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS One. 2016 Feb 5;11(2):e0148343. doi: 10.1371/journal.pone.0148343. eCollection 2016.
citation: Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi M, Althabe F. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World health report 2010, 30: 1-31.
citation: Ministry of Health and Population [Egypt], El-Zanaty and Associates [Egypt], and ICF International. 2015. Egypt Demographic and Health Survey 2014. Cairo, Egypt and Rockville, Maryland, USA: Ministry of Health and Population and ICF International.
citation: Thomas J, Paranjothy S. Royal College of Obstetricians and Gynaecologists Clinical Effectiveness Support Unit. National Sentinel Caesarean Section Audit Report. London: RCOG press; 2001.