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LTMG Sion Hospital devise ‘Sion Model’, reduce C-sections by 5%

In an attempt to reduce the incidence of caesarean section, civic-run LTMG Sion Hospital, a tertiary referral center for complex obstetric cases, devised a ‘Sion Model’ that has reduced C-sections by 5% in the last six months.

A study of 131 pregnant women showed counseling and patient education are key to promoting vaginal birth. ‘Reducing C-section rates is crucial in improving maternal and neonatal health,’ said Dr Niranjan Chavan, the professor who led the study.

In the ‘Sion Model,’ a ‘24 Foley catheter’ is used to induce labour at term. ‘It helps facilitate natural delivery, whether it’s the woman’s first or second pregnancy,’ he said. The hospital’s gynaecology department comprises six units. Each unit manages 60 emergencies a year, with approximately 1,500 to 1,700 deliveries annually. In Dr Chavan’s study, 45 patients (34%) were ‘primigravida’ (women expecting for the first time) and 86 patients (66%) were ‘multigravida’ (who had previous childbirths). ‘Out of 45 ‘primigravida,’ 40 patients (90%) wished for normal vaginal delivery, and 5 (10%) feared labour pain and opted for a caesarean section,’ he said. Of the 86 ‘multigravida,’ 15 had one previous caesarean section. Of these, 10 patients (66.7%) wanted to undergo a trial of labour as vaginal birth is natural, while five wanted a repeat caesarean section as they also wanted to undergo tubectomy.

Since July 2023, Dr Chavan’s unit has been counselling patients on the mechanical dilatation method. “A Foley catheter is readily available in public hospitals. It, in combination with Dinoprostone gel, is ideal for elective induction of labour at 39 weeks,” said Dr Chavan. However, he added that not all women can opt for natural delivery.

Dr Chavan, who is also a member of the Mumbai Obstetrics and Gynaecology Society, emphasized the need to reduce the C-section rates. ‘There is a risk that by 2050, vaginal deliveries might be relegated to history books,’ he said. Hindustan Times

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