Types of Cesarean Measures
What is the NTSV Cesarean Birth Measure?
The Cesarean Birth measure used by The Joint Commission breaks down primary cesarean rates into something that can be used to more fairly compare hospitals. Also known as PC-02, it measures only patients whose outcomes are shown to be largely influenced by physician factors. Over 60% of hospital variation in NTSV cesarean birth rates can be attributed to first birth labor induction rates and being admitted too early to the hospital in a first birth.
What does NTSV stand for?
N= Nulliparous, or first-time moms
T= Term pregnancy
S= Singleton (not twins, triplets or more)
V= Vertex, meaning the baby was head-down
Other Types of Cesarean Birth Measures
The terms "cesarean rate" and C-section rate" can refer to different measures:
Total cesarean rates are all cesareans divided by all live births.
Primary cesarean rates refer to first-time cesarean births regardless of how many babies a mom has already had.
The low-risk primary cesarean rate (AHRQ IQI 33) is first cesarean births among a population with "low-risk" births (the TSV part of NTSV).
Society for Maternal Fetal Medicine recently developed a cesarean birth measure similar to IQI 33, referred to as the SMFM Cesarean Birth Measure, which looks at the TSV population with additional high-risk conditions excluded from the denominator, such as placenta previa, placenta accreta, eclampsia, HIV, and others. This measure is not commonly used.
As of 2015, World Health Organization recommends the use of the Robson classification as a global standard for assessing, monitoring and comparing cesarean birth rates at the facility level. According to WHO, the system “classifies all women into one of 10 categories that are mutually exclusive and, as a set, totally comprehensive. The categories are based on 5 basic obstetric characteristics that are routinely collected in all maternities (parity, number of foetuses, previous caesarean section, onset of labour, gestational age, and fetal presentation).”