Document Detail

Maternal and neonatal adverse outcome at repeat cesarean delivery versus repeat vaginal delivery.
MedLine Citation:
PMID:  21333238     Owner:  NLM     Status:  In-Data-Review    
Objective: To determine selected maternal and neonatal adverse outcomes at repeat cesarean delivery compared with repeat vaginal delivery. Study Design: Cross-sectional study. Place and Duration of Study: Lyari General Hospital, Karachi, from January 2005 to December 2008. Methodology: Healthy pregnant women at 28-42 weeks of second singleton pregnancy were selected for study. Those with previous cesarean birth was labelled the exposed group and those with previous vaginal birth were considered the control group. Maternal and neonatal morbidity's attributable to the previous cesarean section was estimated. Potential confounders like persistent medical disorders, previous adverse outcome and trial of scar cases was excluded. Results were presented in frequency and percentage. Effects of outcomes were calculated as odds ratio with 95% confidence interval. SPSS-16 was used for statistical data analysis. Results: A total of 195 mothers at repeat cesarean delivery were compared with 1486 mothers at repeat vaginal delivery. Mothers with previous cesarean birth were at high risk of peripartum hysterectomy and placenta accrete followed by placenta praevia [OR 7.6 (95% CI = 0.48-122.8), 7.6 (0.48-122.8) and 2.5 (0.68-9.6) respectively]. Very preterm birth [OR = 3.86, 95% CI 1.15-12.97)] was the most significant neonatal adverse outcome. Conclusion: Cesarean section in first pregnancy conferred an additional risk in the second pregnancy even after exclusion of known complications of trial of scar. These should be part of overall clinical assessment at the time of first cesarean section.
Shakira Perveen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the College of Physicians and Surgeons--Pakistan : JCPSP     Volume:  21     ISSN:  1022-386X     ISO Abbreviation:  J Coll Physicians Surg Pak     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606447     Medline TA:  J Coll Physicians Surg Pak     Country:  Pakistan    
Other Details:
Languages:  eng     Pagination:  84-7     Citation Subset:  IM    
Dow University of Health Sciences, Civil Hospital, Karachi.
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