Private Ob. Gyns. Less Adherent to C-Section Criteria


ORLANDO — Hospital teaching staff was more likely to adhere to American College of Obstetricians and Gynecologists' guidelines for scheduling cesarean deliveries than were physicians in private practice, according to a retrospective chart review, Dr. M. Ryan Laye said at the annual meeting of the South Atlantic Association of Obstetricians and Gynecologists.

However, this nonadherence did not result in an increase in adverse neonatal outcomes, said Dr. Laye, who was at Greenville (S.C.) Memorial Hospital when the study was conducted.

Of the 296 patients being delivered by scheduled cesarean section for elective indications at the hospital, 222 (75%) were delivered in accordance with the American College of Obstetricians and Gynecologists' recommendations for timing of elective delivery. Of those not adhering, 95.5% were private service patients, and 4.5% were teaching service patients. The admission rate for the neonatal intensive care unit in both groups was 3.7%, which is consistent with the rates for all cesarean deliveries, as reported in the neonatal literature, Dr. Laye said.

Teaching-staff patients were more likely to be nonwhite, younger, and more obese than were the private service patients. They were also less likely to undergo a primary elective cesarean delivery, with 4 of 109 teaching staff patients (3.6%), and 23 of 187 private service patients (12.3%) undergoing a primary elective cesarean delivery, said Dr. Laye, now at the University of Mississippi Medical Center in Jackson.

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