Conclusion
High level classification of intrapartum CS using totally inclusive but
also mutually exclusive objective criteria is useful for interpretation
of clinical practice. Detailed and more subjective clinical indications
are more useful used within the ICSCS and within the overarching
structure of the TGCS.
We successfully tested a ICSCS in a prospective nationwide study. The
system can be easily taught, and we recommend including it as part of
routine perinatal data collection. It may become a valuable objective
tool for analyzing and improving the management of labour.
Acknowledgement
We thank the Norwegian Medical Association (Anne Sofie Torp and Audun
Fredriksen) for generous financial and administrative support. The
professional assistance from the staff at the Medical Birth Registry of
Norway was a guarantee for successful data collection and processing.
Finally, we are grateful for the tremendous efforts from the
participating units: Sørlandet Hospital Arendal (Karin Lillejord
Kristoffersen, Ole Georg Torjusen), Haukeland University HospitalBergen (Anne Tandberg), Norland Hospital Bodø (Hiba
Mohammed, Hild Mæland), Bærum Hospital (Helene Heide),Drammen Hospital (Angeline Styve Einarsen, Anne Molne
Kjøllesdal), Innlandet Hospital Elverum (Hanne Maartmann),
Østfold Hospital Fredrikstad (Britt Helene Skaar Udnæs, Guri
Kristine Vognild), Førde Hospital (Mette Kristine Hjertaas, Randi
Mette Sygard Steen,), Innlandet Hospital Gjøvik (Wenche Hauso,
Marthe Ulven), Hammerfest Hospital (Ingjerd Røeggen),Haugesund Hospital (Thomas Hahn, Kristin Urnes), Ringerike
Hospital Hønefoss (Anne Grønnevik, Silje Skaar Moe, Hege Kristin
Navrud), Sørlandet Hospital Kristiansand (Bente Maltby),Levanger Hospital (Marit Heggdal), Innlandet HospitalLillehammer (Ann Hilde Berg, Anna Danielsson), Akershus
University Hospital Lørenskog (Eli Aaby, Helene Normann Furnes,
Nicola Janowitz, Gro Merete Overrein, Eva Ringnes, Sylvia Rugaas),Namsos Hospital (Lars Derås, Sonny Anitha Wibstad), OsloUniversity Hospital Ullevål (Kristin Bøhn, Linda Björk Helgadottir,
Thorbjørn Brook Steen, Marit Øgaard), Oslo University Hospital
Rikshospitalet (Anne-Sofie Letting, Ingvil Krarup Sørbye), Telemark
Hospital Skien (Stig Alexander Hill, Kevin Sunde Oppegård), St
Olav Hospital Trondheim (Kirsti Myklestad, Tone Selmer-Olsen,
Britt Sissel Aarseth Vedvik), Vestfold Hospital Tønsberg (Hårek
Augestad Lysberg, Linn Tokheim Nistov), Nordland HospitalVesterålen (Kristen Olav Lind), Ålesund Hospital (Sissel
Hjelle, Lena Hüttner).
Disclosure of interests: None declared.
Contribution to authorship: JK initiated the project and national data
collection, performed the data analysis, and drafted the manuscript. MR
gave support in teaching the ICSCS to the collaborators from
participating units and participated in the interpretation of data and
revision of the manuscript. Apart from their role as local project
collaborators FM, JR and CT participated in data interpretation and
revision of the manuscript.
Details of ethics approval: The study was approved by the Research
Ethics Committee (REK Nord 2018/1682-3). Data collection to the Medical
Birth Registry of Norway is mandatory and does not require consent form
the women.
Funding: The study received funding from the Norwegian Medical
Association, fund of quality improvement and patient safety.
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