Document Detail

Maternal morbidity associated with cesarean delivery without labor compared with spontaneous onset of labor at term.
MedLine Citation:
PMID:  12962927     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To estimate the maternal morbidity associated with cesarean deliveries performed at term without labor compared with morbidity associated with spontaneous labor. METHODS: A 14-year, population-based, cohort study (1988-2001) using the Nova Scotia Atlee Perinatal Database compared maternal outcomes in nulliparous women at term undergoing spontaneous labor for planned vaginal delivery with singleton, cephalic presentation and nulliparous women delivering by cesarean without labor. RESULTS: From a total of 18,435 pregnancies, which satisfied inclusion and exclusion criteria, 721 were cesarean deliveries without labor. There were no maternal deaths or transfers for intensive care. There was no difference in wound infection, blood transfusion, or intraoperative trauma. Women undergoing cesarean deliveries without labor were more likely to have puerperal febrile morbidity (relative risk [RR] 2.2; 95% confidence interval [CI] 1.1, 4.5; P=.03), but were less likely to have early postpartum hemorrhage (RR 0.6; 95% CI 0.4, 0.9; P=.01) compared with women entering spontaneous labor. Subgroup analyses of maternal outcomes in women delivering by spontaneous and assisted vaginal delivery and cesarean delivery in labor were also performed. The highest morbidity was found in the assisted vaginal delivery and cesarean delivery in labor groups. CONCLUSION: The increased maternal morbidity in elective cesarean delivery compared with spontaneous onset of labor is limited to puerperal febrile morbidity. Maternal morbidity is increased after assisted vaginal delivery and cesarean delivery in labor compared with cesarean delivery without labor.
V M Allen; C M O'Connell; R M Liston; T F Baskett
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  102     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-09     Completed Date:  2003-10-15     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  477-82     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada.
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MeSH Terms
Cesarean Section / adverse effects*,  methods
Cohort Studies
Confidence Intervals
Follow-Up Studies
Gestational Age
Labor Onset
Labor Presentation
Labor, Obstetric*
Maternal Age
Maternal Mortality / trends
Morbidity / trends*
Nova Scotia
Postpartum Hemorrhage / diagnosis*,  epidemiology
Pregnancy Outcome
Retrospective Studies
Risk Assessment
Uterine Rupture / diagnosis*,  epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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