Cesarean section rates are rising globally due to medically unnecessary procedures. This stepped-wedge, cluster-randomized pilot trial in four Indian hospitals evaluated the World Health Organization Labour Care Guide (LCG) strategy intervention against routine care. The primary outcome (cesarean rate in Robson Group 1) showed a 5.5% crude absolute reduction (45.2% vs 39.7%), though not statistically significant. Labor augmentation with oxytocin was significantly lower with the LCG strategy. Other outcomes showed no significant differences. Findings suggest the LCG strategy warrants further investigation in larger trials.
Publisher
Nature Medicine
Published On
Feb 16, 2024
Authors
Joshua P. Vogel, Yeshita Pujar, Sunil S. Vernekar, Elizabeth Armari, Veronica Pingray, Fernando Althabe, Luz Gibbons, Mabel Berrueta, Manjunath Somannavar, Alvaro Ciganda, Rocio Rodriguez, Savitri Bendigeri, Jayashree Ashok Kumar, Shruti Bhavi Patil, Aravind Karinagannanavar, Raveendra R. Anteens, Pavithra Mallappa Ramachandrappas, Shukla Shetty, Latha Bommanal, Megha Haralahalli Mallesh, Suman S. Gaddi, Shaila Chikkagowdra, Bellara Raghavendra, Caroline S. E. Homer, Tina Lavender, Pralhad Kushtagi, G. Justus Hofmeyr, Richard Derman, Shivaprasad Goudar
Tags
Cesarean section
Labour Care Guide
pilot trial
healthcare intervention
maternal health
oxytocin
India
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