When a caesarean section is necessary: Analysis of cesarean sections performed in the Republic of Turkey in 2022 in accordance with the World Health Organization Multi-Country Research Guidelines

Objective

The aim of our study, in light of the World Health Organization Multi-Country Survey (WHO-MCS) data examining the data of the Ministry of Health for the year 2022, comparing the cesarean sections (C/S) performed in the Republic of Turkey (TR) with the WHO-MCS data, and comparing the number of cesarean sections applied more than the reference values.

Materials and Methods

According to the database of the Turkish Ministry of Health, in 2022, 1166175 deliveries took place in the Republic of Turkey, and 706370 (60.5%) cesarean section deliveries were recorded as 365764 (51%) primary C/S. Using the Ministry of Health registration system based on the Robson classification.

Results

The number and rate of C/S operations performed per birth in 2022 in TR (n=706370; 60.50%) were found to be significantly higher when compared to the number and rate of C/S on a global scale (n=246062; 21.10%), (p<0.001). When cesarean section operations performed in the Ministry of Health hospitals, private institutions, foundation universities, public universities and other public unit hospitals were compared with WHO MCS reference values and C/S ratios, 44.2% versus 24.7% (p=0.05), versus 77.4%, versus 34.2% (p<0.001), 74.3% versus 29.5% (p<0.001), 75% versus 35.8% (p<0.001), 69.3% versus 35.9% (p<0.001).

Conclusion

The amount of cesarean sections performed according to the total number of births in the Turkish Republic is relatively high and its cost nearly 1 billion 750 million TL.

How Effective are Intensive Care Unit Beds Used in Our Region?

Objective

The demand for critical care facilities is also growing in our country. The aim of the present study was to investigate the incidence and causes of inappropriate admissions to adult intensive care units (ICUs) in our region to facilitate the planning of bed numbers.

Methods

A team of specialists made an unannounced visit to level 1, 2 and 3 adult ICUs in 12 hospitals in our region between June 2014 and January 2015. A total of 290 ICU patients were evaluated.

Results

The rate of inappropriate ICU admission was 55.9%, and the most common reason was the lack of a lower level ICU. Palliative patients comprised 35.5% of the ICU patients, 68% of whom should have been in home care. The rate of inappropriate admission was 16.7% higher in open ICUs than in closed ICUs.

Conclusion

Our results indicate that instead of increasing the number of beds in level 2 and 3 ICUs, hospitals should increase the number of level 1 ICU beds. In addition, we believe that the existing beds could be utilised more effectively if all ICUs implemented a closed management style and if there was better coordination between ICUs.