A decade’s experience in primipara, term, singleton, vertex parturients with a sustained low rate of CD
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Misgav Rottenstreich
,
Aharon Tevet
Abstract
Background
Cesarean delivery (CD) in primiparas with a term singleton vertex fetus (PTSV) is a sentinel event for the future mode of delivery and determinant of repeat CD risk. We aimed to evaluate the risk factors for primary CD in a population with a decade of sustained low rate of intrapartum CD.
Methods
This was a retrospective single-center cohort study between 2005 and 2014. The primary outcome of the study was the mode of delivery. PTSV who attempted vaginal delivery were identified and categorized according to the mode of delivery: vaginal delivery vs. CD. Risk factors for intrapartum CD adjusted odds ratio (aOR) [95% confidence interval (CI)] in multivariate analysis were reported.
Results
During the study, 121,483 deliveries were registered; 26,301 (21.6%) PTSV were admitted in labor, of which 1944 (7.4%) had an intrapartum CD. Significantly in multivariate analysis, this group had a unique risk profile as compared to those who delivered vaginally; non modifiable risks included advanced maternal age: 3.06 (2.16–4.33), P < 0.001; prior multiple (≥3) miscarriages: 1.94 (1.04–3.62), P = 0.04; low (<6) modified admission cervical score: 2.41 (2.07–2.82), P < 0.001; low birth weight (BW): 1.42 (1.00–2.01), P = 0.05 or macrosomia: 2.38 (1.77–3.21), P < 0.001; modifiable risks included induction of labor: 1.79 (1.51–2.13), P < 0.001 and oxytocin labor augmentation: 8.36 (6.84–10.22), P < 0.001.
Conclusion
In a population of PTSV with a sustained low risk for intrapartum cesarean maintained by a strict labor management, induction of labor remains a significant and sole potentially modifiable risk factor for CD.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Boyle A, Reddy UM. Epidemiology of cesarean delivery: the scope of the problem. Semin Perinatol 2012;36:308–14.10.1053/j.semperi.2012.04.012Suche in Google Scholar PubMed
2. Coonrod DV, Drachman D, Hobson P, Manriquez M. Nulliparous term singleton vertex cesarean delivery rates: institutional and individual level predictors. Am J Obstet Gynecol 2008;198:694.e1–11.10.1016/j.ajog.2008.03.026Suche in Google Scholar PubMed
3. Joint Commission. Measure information form PC-02 cesarean section rate. Perinatal care core measure set. Specifications manual for Joint Commission national quality measures (v2015A1) n.d. https://manual.jointcommission.org/releases/TJC2015A1/MIF0167.html Accessed 22 Jun 2018.Suche in Google Scholar
4. American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine. Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery. Obstet Gynecol 2014;123:693–711.10.1097/01.AOG.0000444441.04111.1dSuche in Google Scholar PubMed
5. Kramer MS, Platt RW, Wen SW, Joseph KS, Allen A, Abrahamowicz M, et al. A new and improved population-based Canadian reference for birth weight for gestational age. Pediatrics 2001;108:E35.10.1542/peds.108.2.e35Suche in Google Scholar PubMed
6. Banos N, Migliorelli F, Posadas E, Ferreri J, Palacio M. Definition of failed induction of labor and its predictive factors: two unsolved issues of an everyday clinical situation. Fetal Diagn Ther 2015;38:161–9.10.1159/000433429Suche in Google Scholar PubMed
7. Kilpatrick S, Garrison E. Normal labor and delivery. In: Gabbe S, editor. Obstetrics: normal and problem pregnancies, 7th ed. Philadelphia, PA, USA: Elsevier Inc.; 2017. p. 246–70.10.1016/B978-0-323-32108-2.00012-3Suche in Google Scholar
8. Armstrong JC, Kozhimannil KB, McDermott P, Saade GR, Srinivas SK. Comparing variation in hospital rates of cesarean delivery among low-risk women using 3 different measures. Am J Obstet Gynecol 2016;214:153–63.10.1016/j.ajog.2015.10.935Suche in Google Scholar PubMed
9. Saleh AM, Dudenhausen JW, Ahmed B. Increased rates of cesarean sections and large families: a potentially dangerous combination. J Perinat Med 2017;45:517–21.10.1515/jpm-2016-0242Suche in Google Scholar PubMed
10. Thuillier C, Roy S, Peyronnet V, Quibel T, Nlandu A, Rozenberg P. Impact of recommended changes in labor management for prevention of the primary cesarean delivery. Am J Obstet Gynecol 2018;218:341.e1–9.10.1016/j.ajog.2017.12.228Suche in Google Scholar PubMed
11. Makhlouf MA, Clifton RG, Roberts JM, Myatt L, Hauth JC, Leveno KJ, et al. Adverse pregnancy outcomes among women with prior spontaneous or induced abortions. Am J Perinatol 2014;31:765–72.10.1016/j.ajog.2010.10.532Suche in Google Scholar
12. Klemetti R, Gissler M, Sainio S, Hemminki E. At what age does the risk for adverse maternal and infant outcomes increase? Nationwide register-based study on first births in Finland in 2005–2014. Acta Obstet Gynecol Scand 2016;95:1368–75.10.1111/aogs.13020Suche in Google Scholar PubMed
13. Tolcher MC, Holbert MR, Weaver AL, McGree ME, Olson JE, El-Nashar SA, et al. Predicting cesarean delivery after induction of labor among nulliparous women at term. Obstet Gynecol 2015;126:1059–68.10.1097/AOG.0000000000001083Suche in Google Scholar PubMed PubMed Central
14. Nicholson JM, Kellar LC, Henning GF, Waheed A, Colon-Gonzalez M, Ural S. The association between the regular use of preventive labour induction and improved term birth outcomes: findings of a systematic review and meta-analysis. BJOG 2015;122:773–84.10.1111/1471-0528.13301Suche in Google Scholar PubMed
15. Grobman WA, Rice MM, Reddy UM, Tita ATN, Silver RM, Mallett G, et al. Labor induction versus expectant management in low-risk nulliparous women. N Engl J Med 2018;379:513–23.10.1056/NEJMoa1800566Suche in Google Scholar PubMed PubMed Central
16. Kenyon S, Tokumasu H, Dowswell T, Pledge D, Mori R. High-dose versus low-dose oxytocin for augmentation of delayed labour. Cochrane Database Syst Rev 2013:CD007201. doi:10.1002/14651858.CD007201.pub3.Suche in Google Scholar PubMed
17. Junge C, von Soest T, Weidner K, Seidler A, Eberhard-Gran M, Garthus-Niegel S. Labor pain in women with and without severe fear of childbirth: a population-based, longitudinal study. Birth 2018;45:469–77.10.1111/birt.12349Suche in Google Scholar PubMed
18. Grisaru-Granovsky S, Bas-Lando M, Drukker L, Haouzi F, Farkash R, Samueloff A, et al. Epidural analgesia at trial of labor after cesarean (TOLAC): a significant adjunct to successful vaginal birth after cesarean (VBAC). J Perinat Med 2018;46:261–9.10.1515/jpm-2016-0382Suche in Google Scholar PubMed
19. Macfarlane AJ, Blondel B, Mohangoo AD, Cuttini M, Nijhuis J, Novak Z, et al. Wide differences in mode of delivery within Europe: risk-stratified analyses of aggregated routine data from the Euro-Peristat study. BJOG 2016;123:559–68.10.1111/1471-0528.13284Suche in Google Scholar PubMed
20. Essex HN, Green J, Baston H, Pickett KE. Which women are at an increased risk of a caesarean section or an instrumental vaginal birth in the UK: an exploration within the Millennium Cohort Study. BJOG 2013;120:732–3.10.1111/1471-0528.12177Suche in Google Scholar PubMed
©2020 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- 10.1515/jpm-2020-frontmatter1
- Review
- Delivery room handling of the newborn
- Original Articles – Obstetrics
- Examining the validity of a predictive model for vaginal birth after cesarean
- Correlation between endometrial thickness and perinatal outcome for pregnancies achieved through assisted reproduction technology
- Significance of the routine first-trimester antenatal screening program for aneuploidy in the assessment of the risk of placenta accreta spectrum disorders
- A decade’s experience in primipara, term, singleton, vertex parturients with a sustained low rate of CD
- Survey of alongside midwifery-led care in North Rhine-Westfalia, Germany
- Correlation between aneuploidy pregnancy and the concentration of various hormones and vascular endothelial factor in follicular fluid as well as the number of acquired oocytes
- Bacteriuria in pregnancy varies with the ambiance: a retrospective observational study at a tertiary hospital in Doha, Qatar
- Microarray findings in pregnancies with oligohydramnios – a retrospective cohort study and literature review
- Lifestyle characteristics of parental electronic cigarette and marijuana users: healthy or not?
- Influence of maternal HIV infection on fetal thymus size
- Original Articles – Fetus
- Clinical outcome of prenatally suspected cardiac rhabdomyomas of the fetus
- Original Articles – Newborns
- Prolonged ventilation and postnatal growth of preterm infants
- Letter to the Editor
- Neonatal sepsis associated with Lactobacillus supplementation
Artikel in diesem Heft
- 10.1515/jpm-2020-frontmatter1
- Review
- Delivery room handling of the newborn
- Original Articles – Obstetrics
- Examining the validity of a predictive model for vaginal birth after cesarean
- Correlation between endometrial thickness and perinatal outcome for pregnancies achieved through assisted reproduction technology
- Significance of the routine first-trimester antenatal screening program for aneuploidy in the assessment of the risk of placenta accreta spectrum disorders
- A decade’s experience in primipara, term, singleton, vertex parturients with a sustained low rate of CD
- Survey of alongside midwifery-led care in North Rhine-Westfalia, Germany
- Correlation between aneuploidy pregnancy and the concentration of various hormones and vascular endothelial factor in follicular fluid as well as the number of acquired oocytes
- Bacteriuria in pregnancy varies with the ambiance: a retrospective observational study at a tertiary hospital in Doha, Qatar
- Microarray findings in pregnancies with oligohydramnios – a retrospective cohort study and literature review
- Lifestyle characteristics of parental electronic cigarette and marijuana users: healthy or not?
- Influence of maternal HIV infection on fetal thymus size
- Original Articles – Fetus
- Clinical outcome of prenatally suspected cardiac rhabdomyomas of the fetus
- Original Articles – Newborns
- Prolonged ventilation and postnatal growth of preterm infants
- Letter to the Editor
- Neonatal sepsis associated with Lactobacillus supplementation
