Current partner codePEPTIDESDE
NCT07461571·Not applicable·INTERVENTIONAL

Improving Safe Vaginal Deliveries for Delivering Mothers by Implementing an Intervention Package of 11 Evidence-based Practices and Robson Classification at a Semi-urban Hospital in Dhaka, Bangladesh

Status

Completed

Phase

Not applicable

Enrollment

2,475

Locations

1

Results

Not posted

Publications

0

Study summary

What the protocol is testing.

The objective of this study was to assess whether a package of 11 evidence-based maternity practices, combined with routine monitoring and Robson Classification, could reduce C-section rates in a semi-urban hospital in Dhaka, Bangladesh. Our intervention targeted the key drivers of unnecessary caesarean section at CWCH: weak labour monitoring, low use of evidence-based induction/vaginal birth after caesarean (VBAC) criteria, limited consultant oversight of C-section indications, and insufficient antenatal counselling.

Interventions

Treatment arms and agents.

OTHER

Package of 11 evidence-based maternity practices combined with Robson TGCS Classification

The intervention package comprised 11 evidence-based maternity practices designed to reduce unnecessary C-sections and promote safe vaginal deliveries: 1. ANC counselling for expecting mothers. 2. Waiting up to 41 weeks of gestation for spontaneous onset of labour. 3. Risk screening for NVD and induction of labour at term. 4. Assessment of Bishop Score on admission. 5. Supportive care during labour and delivery. 6. Continuous monitoring with CTG. 7. Use of partograph 8. Induction or augmentation of labour as indicated, using prostaglandin or oxytocin for induction, based on Bishop Score. 9. Consultant review of CS indications during ward rounds. 10. Vaginal birth after caesarean (VBAC) for selected cases with appropriate monitoring. 11. Immediate care of the newborn. Additionally, all deliveries were classified using the Robson Ten Group Classification System.

Timeline

From registration to results.

  1. First posted

    Mar 10, 2026

  2. Study start

    Jun 1, 2017

  3. Primary completion

    Feb 10, 2019

  4. Study completion

    Aug 18, 2019

  5. Results posted

    Not reported

  6. Registry updated

    Mar 12, 2026

Outcomes

What the study measures.

Primary outcomes

Caesarean section rate

Time frame · 70 weeks

Proportion of caesarean sections among total deliveries

Secondary outcomes

Absolute and non-absolute indications for caesarean sections

Time frame · 70 weeks

Proportion of absolute and non-absolute indications among all deliveries by caesarean sections. Absolute indications are situations where vaginal delivery is not possible or poses a highly significant risk to the mother or baby. Non-absolute indications are situations where a caesarean section might be considered based on the potential risks and benefits for both the mother and the baby, and vaginal delivery may still be an option. Absolute indications include: obstructed labour, grade 3 or 4 placenta praevia, impending uterine rupture, and malpresentation. Non-absolute indications include: failure to progress in labour, prolonged labour, failed induction, previous caesarean delivery, antepartum haemorrhage, preeclampsia/eclampsia, psychological indication, maternal request, precious (valuable) pregnancy, foetal compromise, and breech presentation.

Robson classification for all deliveries

Time frame · 70 weeks

Robson classification for all deliveries. The Robson classification is a system for classifying pregnant women who undergo childbirth. There are a total of 12 mutually-exclusive groups and subgroups to which every delivering mother is assigned to. These are: 1 Nulliparous, single cephalic, \>=37 weeks, spontaneous labour; 2a Nulliparous, single cephalic, \>=37 weeks, induced labour; 2b Nulliparous, single cephalic, \>=37 weeks, CS before labour; 3 Multiparous (no previous CS), single cephalic, \>=37 weeks, spontaneous labour; 4a Multiparous (no previous CS), single cephalic, \>=37 weeks, induced labour; 4b Multiparous (no previous CS), single cephalic, \>=37 weeks, CS before labour; 5 Multiparous, previous CS, single cephalic, \>=37 weeks; 6 Nulliparous with single breech; 7 Multiparous with single breech (including previous CS); 8 All multiple pregnancies (including previous CS); 9 All abnormal lies (including previous CS); 10 All single cephalic, \<37 weeks (including previous CS).

Absolute CS rate by Robson Classification

Time frame · 70 weeks

Absolute proportion of caesarean sections among all Robson groups. Absolute rate is calculated by: number of caesarean section in the Robson group/total number of deliveries in the hospital \* 100

Relative CS rate by Robson Classification

Time frame · 70 weeks

Relative proportion of caesarean sections among all Robson groups. Relative rate is calculated by: number of caesarean sections in the Robson group/total number of caesarean sections in the hospital \* 100

Eligibility

Who can take part.

Minimum age
Not reported
Maximum age
Not reported
Sex
FEMALE
Healthy volunteers
No

Inclusion Criteria: \- Admitted into the maternity and labour ward of AWCH for delivery. Exclusion Criteria: * Unable to provide consent * Age is less than 18 years * Refused to participate in the study

Study locations

1 registered sites.

Bangladesh. Showing up to 24 locations stored in the fast local snapshot.

Ashulia Women and Children Hospital

Dhaka, Dhaka Division, Bangladesh

Publications

Results and literature.

No PMID-linked publications were present in this registry snapshot.

Primary links

Continue at the source.

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Put the record in context.

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