ObjectiveTo assess the differences in rates and odds for emergency caesarean section among singleton pregnancies in six governmental Palestinian hospitals.DesignA prospective population-based birth cohort study.SettingObstetric departments in six governmental Palestinian hospitals.Participants32 321 women scheduled to deliver vaginally from 1 March 2015 until 29 February 2016.MethodsTo assess differences in sociodemographic and antenatal obstetric characteristics by hospital, χ2test, analysis of variance and Kruskal-Wallis test were applied. Logistic regression was used to estimate differences in odds for emergency caesarean section, and ORs with 95% CIs were assessed.Main outcome measuresThe primary outcome was the adjusted ORs of emergency caesarean section among singleton pregnancies for five Palestinian hospitals as compared with the reference (Hospital 1).ResultsThe prevalence of emergency caesarean section varied across hospitals, ranging from 5.8% to 22.6% among primiparous women and between 4.8% and 13.1% among parous women. Compared with the reference hospital, the ORs for emergency caesarean section were increased in all other hospitals, crude ORs ranging from 1.95 (95% CI 1.42 to 2.67) to 4.75 (95% CI 3.49 to 6.46) among primiparous women. For parous women, these differences were less pronounced, crude ORs ranging from 1.37 (95% CI 1.13 to 1.67) to 2.99 (95% CI 2.44 to 3.65). After adjustment for potential confounders, the ORs were reduced but still statistically significant, except for one hospital among parous women.ConclusionSubstantial differences in odds for emergency caesarean section between the six Palestinian governmental hospitals were observed. These could not be explained by the studied sociodemographic or antenatal obstetric characteristics.
EP23.07: Ultrasound in labour to predict a need for emergency Caesarean section (ECS): a prospective, blinded cohort study