To evaluate the role of the quality improvement course (QIC) to reduce the caesarean section (CS) rate among nulliparas (Robson groups 1 and 2) and to find out which group of women have reduced the CS rate following attendance at the course. The QIC was organized in 2015. For the evaluation of the CS rate after the OIC, deliveries from the selected hospitals in 2014 and 2016 were compared using MS EXCEL and SPSS 23.0. Nulliparas accounted for 44.6% (3585/8046) and 42.9% (3628/8460) of all the deliveries in 2014 and 2016 years, respectively. The CS rate among nulliparas decreased from 19.0% (665/3502) in 2014 to 16.8% (593/3526) in 2016 (p = 0.018). The greatest decrease in absolute contribution to the overall CS rate was recorded in group 1 (p = 0.08). Perinatal mortality was 3.1 in 2014 and 3.9 in 2016 per 1000 deliveries (p = 0.569). The QIC has helped to reduce the CS rate among nulliparas without a negative influence on perinatal mortality. The greatest decrease in the overall CS rate was recorded among nulliparous women who were treated with oxytocin and managed to reach a full cervical dilatation.

中文翻译：

---

立陶宛减少剖腹产剖宫产的经验：质量改进过程的影响

评估质量改善课程（QIC）在降低原产妇剖腹产（CS）率（罗布森组1和2）中的作用，并找出参加该课程的女性中哪些群体降低了剖腹产（CS）率。QIC于2015年组织。为评估OIC之后的CS率，使用MS EXCEL和SPSS 23.0比较了2014年和2016年选定医院的分娩率。2014年和2016年，Nulliparas分别占所有交付量的44.6％（3585/8046）和42.9％（3628/8460）。原产妇的CS率从2014年的19.0％（665/3502）降至2016年的16.8％（593/3526）（p = 0.018）。在第1组中，对总体CS率的绝对贡献下降最大（p = 0.08）。2014年的围产期死亡率为每1000例分娩3.1例，2016年3.9例（p = 0.569）。QIC有助于降低原产妇的CS率，而对围产期死亡率没有负面影响。在接受催产素治疗并设法达到完全宫颈扩张的未生育妇女中，总CS率下降最大。