THE DUTCH OBSTETRIC INTERVENTION STUDY - VARIATIONS IN PRACTICE PATTERNS

Objective: To compare obstetric intervention rates between Dutch hospi tals. Methods: A total of 28 934 hospital births under secondary care (specialist care for medium-/high-risk pregnancies) in 1990 were analy zed in a stratified, random sample of Dutch hospitals based on the rec ords of the Dutch Netherlands perinatal database. Comparisons were mad e of the intervention rates between hospitals. Results: The interventi on rates of the various hospitals differed widely. The most striking d ifference was in the cesarean section (CS) rate for non-vertex first t wins, with a range of 0-100% and a mean rate of 47.6%. On average a CS for a term breech was performed in 30.8% of cases and sedation or ana lgesics were administered in 16.2% of cases. The mean rate of episioto my for a term breech was 71.5%, the lowest rate being 18.8%. Conclusio n: Our results show relatively low intervention rates with considerabl e interhospital variation.