Question

A hospital’s UM committee discovers that the rate of cesarean section births at the hospital is higher than the rate at other hospitals in the region. A higher percentage of women at other hospitals are having vaginal deliveries. The UM committee wants to evaluate the medical necessity of cesarean section births at the hospital using clinical practice guidelines on this topic. Go to the website of the National Guideline Clearinghouse (www.guideline.gov) to find the most current recommendations that address the indications for a cesarean section birth, and write a summary of the indications for the committee to consider.

Answer 1

Breech presentation, where woman has a uterine scar or abnormality, fetal compromise, ruptured membranes and vaginal bleeding

Multiple pregnancy, perinatal morbidity and mortality is high for the second twin

Placenta previa, women with a placenta that partly or completely covers the internal cervical OS

Cephalopelvic disproportion in labour

Mother to child transmission of maternal infection such as HIV, Hepatitis B virus, Hepatitis C virus and herpes simplex virus.

Maternal request for cesarean section. After exploring discussing and documenting the specific reasons and explaining the complications of cesarean section over vaginal delivery and recorded