Document Detail

Prevention of the first cesarean delivery: the role of operative vaginal delivery.
MedLine Citation:
PMID:  23009970     Owner:  NLM     Status:  In-Data-Review    
While the cesarean delivery (CD) rates have increased worldwide, operative vaginal delivery (OVD) rates continue to decline, with the United States having some of the lower rates amongst developed countries. It is clear that the use of forceps or vacuum can safely assist in accomplishing a vaginal delivery and prevent a cesarean during the IInd stage of labor performed for a variety of maternal or fetal indications. In the absence of randomized trials between OVD's and immediate CD's for anticipated difficult births the question of the balance of risks between the two interventions remains unanswered. Properly performed OVD's are associated with lower maternal morbidity compared with cesarean, without an increase in significant neonatal morbidity. In order to reverse the current trends and for these skills to continue active training in OVD's is clearly needed during and after residency. The availability of clinicians with expertise in OVD's should aid in decreasing the rates of CD and the training of newer generations of practitioners. The professional endorsement of OVD's is also fundamental not only to frame the practice for physicians but to promote and improve the general acceptance of assisted deliveries and facilitate the societal discourse to reduce CD rates.
Alfredo F Gei
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in perinatology     Volume:  36     ISSN:  1558-075X     ISO Abbreviation:  Semin. Perinatol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7801132     Medline TA:  Semin Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  365-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Sciences Center, Houston, TX. Electronic address:
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