Fostering Excellence in Obstetrical Surgery

Abstract

Introduction

This obstetric surgery review is directed toward the common obstetrical surgeries (caesarean delivery, VBAC/TOLAC, operative vaginal delivery, placenta accreta spectrum) with evidence for quality and safety to allow for obstetrical outcome excellence.

Materials and Methods

This focused scoping review has used a structured process for article identification and inclusion for each of the focused surgeries.

Results

The review results provide an obstetrical surgery (OS) overview for caesarean delivery, vaginal birth after caesarean delivery and/or trial of labor after caesarean delivery, operative vaginal delivery, placenta accreta spectrum; considerations for quality and safety variance due to non-clinical human factors; quality improvement (QI) tools; OS QI implementation cohorts; implementation considering certain barriers and solutions.

Conclusion

Administrative health care systems and obstetrical surgery care providers cannot afford, not to consider and implement, certain evidenced-based “bottom-up/top-down” processes for quality and safety, as the patients will demand the quality and the safety, but the lawyers should not have to enforce it.

Keywords:

• obstetrical safety
• obstetrical quality
• obstetrical morbidity
• caesarean delivery
• vaginal birth after caesarean delivery
• trial of labor after caesarean delivery
• operative vaginal delivery
• placenta accreta spectrum
• implementation process

Acknowledgment

No funding or AI was used in this work.

Disclosure

The author reports no conflicts of interest in this work.