Document Detail

Trends in the modes of delivery and their impact on perinatal mortality rates.
MedLine Citation:
PMID:  15243667     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine changes in the incidence of vaginal deliveries, cesarean sections, and forceps deliveries and their potential association with fetal, early neonatal, and perinatal mortality rates over time. METHODS: A retrospective study was carried out and the occurrence of deliveries supervised by university services between January 1991 and December 2000 was determined. Data regarding fetal, early neonatal, and perinatal deaths were assessed using obstetric and pediatric records and autopsy reports. RESULTS: Of a total of 33,360 deliveries, the incidence of vaginal deliveries, cesarean sections, and forceps deliveries was relatively steady (around 60, 30, and 10%, respectively) while, at the same time, there was a marked reduction in fetal mortality (from 33.3 to 13.0 per thousand), early neonatal mortality (from 30.6 to 9.0 per thousand), and perinatal mortality (from 56.4 to 19.3 per thousand). CONCLUSIONS: The marked reduction in perinatal mortality rates seen during the study period without an increase in cesarean sections indicates that the decrease in perinatal mortality was not impacted by cesarean section rates. The plausible hypothesis seems to be that the reduction in perinatal mortality of deliveries performed under the supervision of university services was more likely to be associated with better neonatal care rather than the mode of delivery.
Geraldo Duarte; Pedro S Coltro; Rebeca V Bedone; Antonio A Nogueira; Glauce M Gelonezzi; Laércio J Franco
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Publication Detail:
Type:  Journal Article     Date:  2004-07-08
Journal Detail:
Title:  Revista de saúde pública     Volume:  38     ISSN:  0034-8910     ISO Abbreviation:  Rev Saude Publica     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-07-09     Completed Date:  2005-03-31     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0135043     Medline TA:  Rev Saude Publica     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  379-84     Citation Subset:  IM    
Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
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MeSH Terms
Cesarean Section / statistics & numerical data,  trends
Delivery, Obstetric / trends*
Fetal Mortality
Infant Mortality*
Infant, Newborn
Natural Childbirth / statistics & numerical data,  trends
Retrospective Studies
Surgical Instruments / statistics & numerical data,  trends

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