Obstetric Quality and Safety
Poster Session 1
Zvi Ehrlich, MD
Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel
rivka Farkash, MPH
Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel
Ari Weiss, MD, MPH (he/him/his)
Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel
Shirley Shapira, MD
Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel
Sorina Granovsky Grisaru, MD,PhD
head of Obstetrics & Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel
Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel
Shunit Armon, MD
Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel
Tzuria Peled, MD (she/her/hers)
Dr, OBGYN, SZMC
Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel
Post partum maternal readmission is a significant burden for mother, neonate and family as well as health system. The post-partum readmission rate is used to evaluate quality of care and to guide beneficial interventions. Thus, identifying women at risk for readmission is of high value.
The WHO established the internationally used Robson group (RG) classification as an optimal measure of caesarean section (CS) rates
Although intended for evaluation of CS rates, in recent years the utilization of the RG classification has been expanded to evaluate other obstetrical outcomes.
We aim to describe the rates of postpartum maternal readmission across RG classification and to identify risk groups.
Study Design:
Retrospective register-based cohort study of women who delivered at a tertiary medical center. All women were classified into 1 of the 10 RGs. Rates of post-partum readmission within 42 days of delivery were calculated for each group.
Results:
A total of 295,215 deliveries were classified to the 10 Robson classification groups. The 42-day readmission rate for the whole database was 0.52%. Maternal readmission rate varied significantly between RGs. Groups identified with a significant rate of maternal readmission were RG 9 (transverse lie) 2.14%, RG 8(multifetal pregnancies )1.37%, RG 7 (multiparous breech pregnancies)1.23% and RG2 (nulliparous pregnancies ≥ 37 w, labor induction' or prelabor cesarean) 1.21%.
Conclusion:
Post partum readmission rates varies among the RGs. Interventions aimed to lower the number of women in RG 2,7,8 and 9; such as use of external cephalic version, vaginal delivery of breech and multifetal pregnancies may be beneficial. The neonatal impact of such policy remains to be considered for each center.