Evidence map›Paper›PMID 40604600›Full record

ArticleBMC pregnancy and childbirth2025

Mandatory second opinion to reduce caesarean section rate among low-risk pregnant women at a private tertiary hospital, a pre and post intervention study: an analysis using WHO Robson classification.

Gregory Ntiyakunze, Amri Kyaruzi, Lynn Moshi, Munawar Kaguta, Jaiswal Shweta, Willbroad Kyejo, Tumbwene Mwansisya, Harrison Chuwa, Muzdalifat Abeid

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Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Gregory NtiyakunzeDepartment of Obstetrics and Gynecology, The Aga Khan University, P.O. Box 38129, Dar Es Salaam, Tanzania. gregory.ntiyakunze@akhst.org.
Amri KyaruziDepartment of Quality and Patient Safety (QPS), The Aga Khan Hospital, Dar Es Salaam, P.O. Box 2289, Dar Es Salaam, Tanzania.
Lynn MoshiDepartment of Obstetrics and Gynecology, The Aga Khan University, P.O. Box 38129, Dar Es Salaam, Tanzania.
Munawar KagutaDepartment of Obstetrics and Gynecology, The Aga Khan University, P.O. Box 38129, Dar Es Salaam, Tanzania.
Jaiswal ShwetaDepartment of Obstetrics and Gynecology, The Aga Khan University, P.O. Box 38129, Dar Es Salaam, Tanzania.
Willbroad KyejoDepartment of Family Medicine, The Aga Khan University, P.O. Box 38129, Dar Es Salaam, Tanzania.
Tumbwene MwansisyaSchool of Nursing and Midwifery, The Aga Khan University, P. O. Box 38129, Dar Es Salaam, Tanzania.
Harrison ChuwaDepartment of Internal Medicine, The Aga Khan University, P.O. Box 38129, Dar Es Salaam, Tanzania.
Muzdalifat AbeidDepartment of Obstetrics and Gynecology, The Aga Khan University, P.O. Box 38129, Dar Es Salaam, Tanzania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCaesarean section rate has increased globally even among low-risk obstetric deliveries. Therefore, more mothers and babies are subjected to potential complications associated with caesarean section. Hence, World Health Organization introduced measures to reduce unnecessary caesarean section, including worldwide accepted means of classifying all deliveries by the Robson's classification system and recommended safe non-medical interventions, such as mandatory second opinion prior caesarean section. Thus, this study aimed at comparing caesarean section rate pre and post introduction of mandatory second opinion prior caesarean section among low-risk pregnant women at a private hospital using Robson classification. METHODOLOGY: This was a pre and post intervention study design, conducted at tertiary private hospital. Data were collected from all deliveries before intervention period from May 2022 to December 2022 and after intervention from May 2023 to December 2023. The intervention was mandatory second opinion prior caesarean section for deliveries in group one and two. The relative risk was calculated to compare caesarean section rate before and after mandatory second opinion at the 95% confidence interval. T-test and Chi-square were used to compare the pregnancy outcome in pre and post intervention periods. Statistical significance was determined at p-value of < 0.05.

resultsTotal deliveries were 941 and 1107 before and post intervention period respectively. Caesarean section rate was 45.5% and 41.3% among low-risk groups (group one and two) in pre intervention and post intervention periods, relative risk of 0.921(95% CI: 0.75-1.11). There was no statistical significance regarding pregnancy outcome.

conclusionThis study illustrated high caesarean section rate in all Robson's groups. Mandatory second opinion alone had no statistical significance in reducing the Caesarean Section rate and impact on the pregnancy outcomes. Therefore, to reduce the rate of caesarean section interventions targeting patients, health care workers and health system may effectively tackle the drivers of elevated caesarean section rates, leading to substantial reductions at both the facility and national levels.

Indexed as

Cesarean SectionReferral and ConsultationUnnecessary ProceduresAdultFemaleHospitals, PrivateHumansPregnancyPregnancy OutcomeTertiary Care CentersWorld Health OrganizationInterventionLow-risk pregnancyMandatory second opinionWHO Robson classification

Identifiers

PMID40604600
PMCPMC12225064

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