APPROPRIATENESS OF CESAREAN SECTION IN A HOSPITAL OF SICILY (ITALY): STATISTIC EVIDENCES AND MEDIC LEGAL CONSIDERATIONS

ntroduction: Authors have carried out a survey to evaluate the appropriateness of the caesarean deliveries performed in a hospital of Sicily (Italy) during 2013. The choices of these surgeries have been compared with italian and sicilian guidelines. Materials: EpiInfo 7.1.4 software (CDC - Atlanta - USA) was used to perform the statistical data analysis (chi-square test). Results: We analyzed a total of 818 medical records related to 50.61% of spontaneous deliveries, :06% induced labor, and 46.33% of cesarean deliveries. Medical records showed that in 32.7% the caesarean section were justified by emergency conditions, whereas in 15.89% the choice was not quite justified according to guidelines parameters. In 39.57% the choice of caesarean delivery is not adequately justified either because the 5.04% is indicated as the reason the request of the woman, and because in 34.53% are not present in the medical record elements sufficient justification as incomplete or absent. Conclusions: More significant results lead to the conclusion that it's important focusing the attention to multiple social and sanitary strategies aimed at not only reducing health care spending but especially encouraging health professionals and pregnant women towards greater responsability in the choices of caesarean delivery for aspects of clinical risk and legal liability.