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A Journal on Forensic Medicine
Minerva Medicolegale 2014 December;134(4):193-200
Appropriateness of cesarean section in a hospital in Sicily (Italy): statistic evidences and medico-legal considerations
Ventura Spagnolo E. 1, Cannavò G. 2, Zerbo S. 1, Mondello C. 3, Cardia L. 3, Argo A. 1, Cardia G. 3
1 Dipartimento di Biotecnologia e Medicina Legale, Università degli Studi di Palermo, Palermo, Italia;
2 Azienda Ospedaliera Universitaria, Policlinico “G. Martino”, Messina, Italia;
3 Dipartimento di Scienze Biomediche e delle Immagini Morfologiche e Strumentali, Università di Messina, Gazzi, Messina, Italia
AIM: The authors have carried out a survey to evaluate the appropriateness of the cesarean deliveries performed in a hospital in Sicily (Italy) during 2013. The use of this option has been judjed based on Italian and Sicilian guidelines.
METHODS: We analyzed a total of 818 medical records related to 50.61% of spontaneous deliveries, 0.06% induced labor, and 46.33% of cesarean deliveries.
RESULTS: Medical records showed that in 32.7% the cesarean sections were due to emergency conditions, whereas in 15.89% the choice was not properly justified according to guidelines parameters. In 39.57% of the analyzed cases the choice of cesarean delivery was not adequately justified: in 5.04% of cases the reason was a direct request of the pregnant woman, in 34.53% of cases the medical records were incomplete.
CONCLUSION: More significant results lead to the conclusion that it is important to focus the attention on multiple social and sanitary strategies aimed at not only reducing health care costs, but especially at encouraging health professionals and pregnant women towards greater responsability.