An observational study in Vaginal Delivery, sponsored by Ain Shams Maternity Hospital. Recruiting at 1 site in Egypt. Open to participants aged 28 Years to 60 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-17.
Sponsored by Ain Shams Maternity Hospital · Observational
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.
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.
Ain Shams Maternity Hospital is the lead sponsor of 139 studies on the registry; 8 are open to participants now.
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Obstetricians from three tertiary maternity hospitals in Cairo, Egypt. The three hospitals are Ain Shams University Maternity Hospital, El Hussein University Hospital, and El Kasr Alaini Hospital
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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
Obstacles preventing the increase in the performance of assisted vaginal birth in Egypt by a questionnaire directed to obstetricians in three maternity tertiary centers in Cairo, Egypt
Time frame: through the study completion, an average of 4 months
Started Jan 2026 (actual). Primary completion is estimated for Jan 2027, 12 months after the start.
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