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dc.contributor.authorLALOR, JOANen
dc.contributor.authorSMITH, VALERIEen
dc.contributor.authorBEGLEY, CECILYen
dc.date.accessioned2015-02-13T15:04:30Z
dc.date.available2015-02-13T15:04:30Z
dc.date.issued2015en
dc.date.submitted2015en
dc.identifier.citationLundgren I, Smith V, Nilsson C, Vehvilainen-Julkunen K, Nicoletti J, Devane D, Bernloehr A, van Limbeek E, Lalor J, Begley C, Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): a systematic review., BMC pregnancy and childbirth, 15, 1, 2015, 16en
dc.identifier.issn1471-2393en
dc.identifier.otherYen
dc.identifier.urihttp://hdl.handle.net/2262/73196
dc.descriptionPUBLISHEDen
dc.description.abstractBackground: The number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives). The aim of this study was to evaluate clinician-centred interventions designed to increase the rate of VBAC. Methods: The bibliographic databases of The Cochrane Library, PubMed, PsychINFO and CINAHL were searched for randomised controlled trials, including cluster randomised trials that evaluated the effectiveness of any intervention targeted directly at clinicians aimed at increasing VBAC rates. Included studies were appraised independently by two reviewers. Data were extracted independently by three reviewers. The quality of the included studies was assessed using the quality assessment tool, ‘Effective Public Health Practice Project’. The primary outcome measure was VBAC rates. Results: 238 citations were screened, 255 were excluded by title and abstract. 11 full-text papers were reviewed; eight were excluded, resulting in three included papers. One study evaluated the effectiveness of antepartum x-ray pelvimetry (XRP) in 306 women with one previous CS. One study evaluated the effects of external peer review on CS birth in 45 hospitals, and the third evaluated opinion leader education and audit and feedback in 16 hospitals. The use of external peer review, audit and feedback had no significant effect on VBAC rates. An educational strategy delivered by an opinion leader significantly increased VBAC rates. The use of XRP significantly increased CS rates. Conclusions: This systematic review indicates that few studies have evaluated the effects of clinician-centred interventions on VBAC rates, and interventions are of varying types which limited the ability to meta-analyse data. A further limitation is that the included studies were performed during the late 1980s-1990s. An opinion leader educational strategy confers benefit for increasing VBAC rates. This strategy should be further studied in different maternity care settings and with professionals other than physicians onlyen
dc.description.sponsorshipWe are grateful to the European Commission for funding this study under the European Union’s Seventh Framework Programme (FP7/2007-2013) through grant agreement no. 305208. The opinions expressed here are those of the study team and are not necessarily those of the European Commission.en
dc.format.extent16en
dc.language.isoenen
dc.relation.ispartofseriesBMC pregnancy and childbirthen
dc.relation.ispartofseries15en
dc.relation.ispartofseries1en
dc.rightsYen
dc.subjectVBAC, Systematic review, Interventions, Cliniciansen
dc.subject.lcshVBAC, Systematic review, Interventions, Cliniciansen
dc.titleClinician-centred interventions to increase vaginal birth after caesarean section (VBAC): a systematic review.en
dc.typeJournal Articleen
dc.type.supercollectionscholarly_publicationsen
dc.type.supercollectionrefereed_publicationsen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/cbegleyen
dc.identifier.peoplefinderurlhttp://people.tcd.ie/lalorj1en
dc.identifier.peoplefinderurlhttp://people.tcd.ie/smithv1en
dc.identifier.rssinternalid100693en
dc.identifier.doihttp://dx.doi.org/10.1186/s12884-015-0441-3en
dc.rights.ecaccessrightsopenAccess
dc.subject.TCDThemeInclusive Societyen
dc.identifier.orcid_id0000-0003-2240-8763en


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