Background
Planned caesarean section (CS) is poorly understood as studies reporting
CS outcomes often combine results for emergency and planned CS or
compare outcomes with actual vaginal births only. This represents a
substantial gap in knowledge as the alternative to planned CS is to plan
a vaginal birth. As emergency CS is usually an outcome of planning
vaginal birth, it is critical that the outcome of planned and emergency
CS are analysed separately. Given that CS rate is rising progressively
with reported rates of 24.5% in Western Europe and 32% in North
America, there is a need for high quality evidence comparing planned CS
to planned VD 1-4.
There is no consensus among patients, healthcare professionals and
researchers regarding the outcome measures that should be collected and
reported in studies assessing planned mode of birth. In absence of a
standardised approach, researchers can only make arbitrary decisions
when choosing among several important outcomes 5.
Furthermore, reporting bias can occur if the outcome is selected
retrospectively based on statistical significance of results6. In order for future studies to be comparable and
for results to be usefully combined, it is crucial for reporting of
outcomes to be consistent 7.
Core outcome sets capture the key outcomes based on what key
stakeholders (clinicians, patients, their partners, researchers, service
developers, funding organisations) consider important in the management
or prevention of a condition 8, 9. Ideally, the
primary outcome and other outcomes of a trial will be selected from a
core outcome set if available, but researchers may continue to explore
other outcomes and are not restricted to the outcomes in the core
outcome set 9.The RCOG and Royal Australian and New
Zealand College of Obstetricians and Gynaecologists (RANZCOG) has formed
the Core Outcomes in Women’s and Newborn’s Health (CROWN) initiative,
which is supported by 80 journals, to tackle unwarranted variation in
outcome reporting by encouraging the publication of studies reporting
outcomes from a core outcome set where available 10,
11.
For a meaningful core outcome set for planned mode of birth to be
developed, evaluation of reported outcomes and outcome measures across
published studies is required 12. The aim of the
present study was to identify and organise the outcomes and outcome
measures reported in prospective studies investigating planned mode of
birth.