Practice of Assisted Vaginal Birth in Egypt

NCT ID: NCT07308977

Last Updated: 2025-12-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

150 participants

Study Classification

OBSERVATIONAL

Study Start Date

2026-01-15

Study Completion Date

2026-05-15

Brief Summary

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In Egypt, the proportion of CSs has been steadily increasing in recent years and has reached an alarming level. According to data from the Royal College of Obstetricians and Gynaecologists (RCOG), approximately 6% of caesarean sections (CS) are performed on average because of inadequate supervision from junior staff members or a lack of training, particularly during the critical decision-making phase of this second stage. The unfamiliarity and lack of experience with operative vaginal delivery is a major cause for the rise in the rate of second stage caesarean section. This survey targets obstetricians with different levels of experience to find practical solutions to increase the rate of assisted vaginal delivery which subsequently will decrease the rate of second stage CS.

Detailed Description

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Egypt is a populous African country with a population of about 102 million people in 2020. Egypt has the highest cesarean section (CS) rate in the Middle East, which has increased from 20% in 2005 to 52% in 2014. Globally, the estimated number of births by Cesarean section (CS) increased from 16 million (12%) in 2000 to 29.1 million (21%) in 2015. Furthermore, during the same period, several studies have demonstrated a remarkable increase in the rate of second-stage cesarean section.

Whereas forceps-assisted vaginal delivery represented 38% of deliveries in rural areas of Egypt, in the United States, operative vaginal delivery in the form of either forceps-assisted vaginal delivery (FAVD) or ventouse-assisted vaginal delivery (VAVD) has declined remarkably since 1990. The utilization of operative vaginal delivery in live births decreased from 9.0% in 1990 to 3.1% in 2016. During the same period, the percentage of VAVD deliveries fell from 3.9 to 2.6%, and FAVD from 5.1 to just 0.5%. The declining rate of assisted vaginal delivery contributed to the rise in the cesarean section rate from 22.7% in 1990 to 31.9% in 2016.

The performance of AVB by physicians with a high level of experience and certified training courses should be considered a safe alternative to second-stage cesarean section. This does not only depend on the physician, but it also depends on the patient's preference. In this survey, the investigators explore Egyptian obstetricians 'attitudes and perceptions on AVB.

Conditions

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Vaginal Delivery

Keywords

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Assisted vaginal delivery

Study Design

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Observational Model Type

OTHER

Study Time Perspective

CROSS_SECTIONAL

Interventions

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Survey using a questionnaire.

This cross-sectional study aims to identify the obstacles preventing an increase in AVB performance in Egypt. Obstetricians from three tertiary care centers in Egypt will be invited to participate in this Online web-based survey over the study period. The questions in this survey are included in 5 sections; demographics, workload and AVB practice, obstetrician-related factors, service provision factors, and what changes could be implemented to increase the rate of uptake of AVB by Egyptian obstetricians. The link to the survey will be sent to the study participants, and the data will be collected for analysis

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Obstetricians with at least 3 years of experience in practicing obstetrics
* Obstetricians with their primary health care facility being one of the three Tertiary centres, Ain Shams University Maternity Hospital, El Hussein University Hospital, and El Kasr Alaini Hospital

Exclusion Criteria

\-
Minimum Eligible Age

28 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Ain Shams Maternity Hospital

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Mohammed Elmaraghy

Assistant professor of Obstetrics and Gynecology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alaa S Elsewafy, M.D.,

Role: STUDY_CHAIR

Faculty of Medicine - Ain Shams university

Mohamed A Haroun

Role: PRINCIPAL_INVESTIGATOR

Faculty of Medicine - Modern University for Technology and Information

Ahmed M Sweidan

Role: STUDY_CHAIR

Faculty of Medicine - Suez University

Central Contacts

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Ahmed M Elmaraghy, M.D,

Role: CONTACT

Phone: +201010370980

Email: [email protected]

Hamdy BM Alqenawy, M.D.,

Role: CONTACT

Email: [email protected]

References

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Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery. Obstet Gynecol. 2014 Mar;123(3):693-711. doi: 10.1097/01.AOG.0000444441.04111.1d.

Reference Type BACKGROUND
PMID: 24553167 (View on PubMed)

Becker DA, Blanchard CT, Szychowski JM, Rogers SL, Brumfield CG, Subramaniam A. Resident Operative Vaginal Delivery Volume after Educational Curriculum Implementation. Am J Perinatol. 2020 Nov;37(13):1296-1300. doi: 10.1055/s-0040-1710543. Epub 2020 May 26.

Reference Type BACKGROUND
PMID: 32455468 (View on PubMed)

Darmstadt GL, Hussein MH, Winch PJ, Haws RA, Gipson R, Santosham M. Practices of rural Egyptian birth attendants during the antenatal, intrapartum and early neonatal periods. J Health Popul Nutr. 2008 Mar;26(1):36-45.

Reference Type BACKGROUND
PMID: 18637526 (View on PubMed)

Banerjee A, Al-Dabbach Z, Bredaki FE, Casagrandi D, Tetteh A, Greenwold N, Ivan M, Jurkovic D, David AL, Napolitano R. Reproducibility of assessment of full-dilatation Cesarean section scar in women undergoing second-trimester screening for preterm birth. Ultrasound Obstet Gynecol. 2022 Sep;60(3):396-403. doi: 10.1002/uog.26027.

Reference Type BACKGROUND
PMID: 35809243 (View on PubMed)

Jadoon B, Assar TM, Nucier AAAR, Raziq HEA, Abd El-Azym Saad AS, Megahed Amer W. Analysis of the caesarean section rate using the 10-Group Robson classification at Benha University Hospital, Egypt. Women Birth. 2020 Mar;33(2):e105-e110. doi: 10.1016/j.wombi.2019.03.009. Epub 2019 Apr 13.

Reference Type BACKGROUND
PMID: 30987799 (View on PubMed)

Fasseeh A, ElEzbawy B, Adly W, ElShahawy R, George M, Abaza S, ElShalakani A, Kalo Z. Healthcare financing in Egypt: a systematic literature review. J Egypt Public Health Assoc. 2022 Jan 7;97(1):1. doi: 10.1186/s42506-021-00089-8.

Reference Type BACKGROUND
PMID: 34994859 (View on PubMed)

Other Identifiers

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20

Identifier Type: -

Identifier Source: org_study_id