Can pre‐eclampsia explain higher cesarean rates in the different groups of Robson's classification?

Sanchez, Mariana Peccia; Guida, José Paulo; Simões, Marcela; Marangoni‐Junior, Marcos; Cralcev, Christopher; Santos, Juliana Costa; Dias, Tábata Z.; Luz, Adriana Gomes; Costa, Maria Laura

doi:10.1002/ijgo.13370

Cited by 13 publications

(16 citation statements)

References 22 publications

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“…Those articles were read in full considering the inclusion and exclusion criteria were considered. Then, ten articles 10 11 12 13 14 15 16 17 18 19 were included in the present review. Figure 1 shows the inclusion flowchart.…”

Section: Resultsmentioning

confidence: 99%

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Prevalence of Preeclampsia in Brazil: An Integrative Review

Guida

Andrade

Pissinatti

et al. 2022

Rev Bras Ginecol Obstet

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Objective To review literature and estimate the occurrence of preeclampsia and its complications in Brazil. Methods We performed an integrative review of the literature, and included observational studies published until August 2021 on the SciELO and PubMed databases that evaluated preeclampsia among pregnant women in Brazil. Other variables of interests were maternal death, neonatal death, hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and eclampsia. Three independent reviewers evaluated all retrieved studies and selected those that met inclusion criteria. A metanalysis of the prevalence of preeclampsia and eclampsia was also performed, to estimate a pooled frequency of those conditions among the studies included. Results We retrieved 304 studies after the initial search; of those, 10 were included in the final analysis, with a total of 52,986 women considered. The pooled prevalence of preeclampsia was of 6.7%, with a total of 2,988 cases reported. The frequency of eclampsia ranged from 1.7% to 6.2%, while the occurrence of HELLP syndrome was underreported. Prematurity associated to hypertensive disorders ranged from 0.5% to 1.72%. Conclusion The frequency of preeclampsia was similar to that reported in other international studies, and it is increasing in Brazil, probably due to the adoption of new diagnostic criteria. The development of a national surveillance network would be essential to understand the problem of hypertensive disorders of pregnancy in Brazil.

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Section: Resultsmentioning

confidence: 99%

“…Overall, 2,988 cases of preeclampsia were reported; the prevalence ranged from 2.31% 11 to 14.15%. 13 Seven studies 10 13 14 15 16 17 18 did not report the occurrence of eclampsia. In the other 3 studies that reported eclampsia, it ranged from 1.66% 19 to 6.19%.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of Preeclampsia in Brazil: An Integrative Review

Guida

Andrade

Pissinatti

et al. 2022

Rev Bras Ginecol Obstet

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“…Robson group 10 added 7.61% to the overall CS rate, illustrating a high number of risk pregnancies, mainly in the middle adolescent group of women. Sanchez et al proved that preeclampsia was associated with the occurrence of CS, owing to higher rates of CS in Robson groups 1, 5, and 10 [22]. We have identified preeclampsia and placental abruption as main indications for CS in Robson group 10, mainly in middle adolescence young mothers.…”

Section: Discussionmentioning

confidence: 51%

Investigating Caesarean Section Practice among Teenage Romanian Mothers Using Modified Robson Ten Group Classification System

Matei

Dimitriu

Roșu

et al. 2021

IJERPH

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The Robson ten-group classification system is a recognized effective method of assessing caesarean rate. It is based on dividing patients into ten mutually exclusive groups, focusing on six maternal and newborn variables (parity, gestational age, plurality, foetal presentation, previous caesarean, and mode of labour onset). The aim of our analysis was twofold: first, to present the implementation of Robson classification in a pregnant teenage population; and second, to identify the indications for CS in the adolescent population. This study was designed as a one-year prospective analysis and considered all women younger than 20 years of age who delivered in a tertiary care hospital. Before discharge, women who had caesarean delivery responded to a questionnaire regarding their education, prenatal surveillance, and obstetrical history. Caesarean sections accounted for 47.01% of all births. A proportion of 24.57% of the participants had at least one previous caesarean section. Group 10 (all women with a single cephalic preterm pregnancy) was second most often identified among women in middle adolescence (14.03%); 32.20% of the participants in late adolescence were in group 5 (multiparas with a scarred uterus, single cephalic term pregnancy). Differences between the two age groups were not statistically different (p = 0.96). Abnormal cardiotocographic findings (38.23%), the arrest of descent (19.11%) and arrest of dilation (19.11%), were the most frequent indications for caesareans in Robson group 1. Neonates from mothers in Robson groups 8 (women with a multiple pregnancy) and 7 (multiparas single breech pregnancy) had the most unfavourable outcomes regarding gestational age at delivery and admission to the intensive care unit. We concluded that future focus on obstetrical management is mandatory in Robson groups 7 and 8. Adolescents in Robson group 1 (nulliparas, single cephalic term pregnancy, spontaneous labour) are the primary beneficiaries of strategies to reduce caesarean sections rates.

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“…This finding is not surprising, given that prematurity and disease-related complications often require a prompt delivery route. [19] These diverse scenarios with severity and phenotypic heterogeneity suggest that PE may result from varied pathogenic pathways. [6,7] Aberrant angiogenesis and systemic inflammation are proposed to be implicated in endothelial dysfunction, being important mediators in PE etiopathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Association of sFlt-1 and C-reactive protein with outcomes in severe preeclampsia

Nóbrega¹,

Katz²,

Lippo³

et al. 2022

Medicine

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To determine the association between soluble FMS-like tyrosine kinase-1 (sFlt-1) and high-sensitivity C-reactive protein (hs-CRP) with maternal and perinatal outcomes in patients with preeclampsia (PE) with severe features.A cohort study was conducted on 100 patients, 60 with PE with severe features, and 40 healthy women in the third trimester of pregnancy. Admission serum levels of sFlt-1 and hs-CRP and clinical and epidemiological parameters were evaluated to quantify the predictive ability of adverse maternal and perinatal outcomes using hierarchical multiple regression and receiver operating characteristic curves.Compared to controls, patients with PE and severe features had significantly higher levels of sFlt-1 but not hs-CRP. sFlt-1 and hs-CRP proved to be reasonable parameters for the prediction of composite adverse maternal outcomes. However, we found no correlation between these 2 biomarkers. PE integrated estimate of risk scores were correlated only with sFlt-1 levels. Regarding fetal outcomes, unlike hs-CRP, sFlt-1 was strongly associated with birth weight and Apgar score <7 at 5 minutes. Following multivariate analysis, maternal age, previous hypertension, sFlt-1, and hs-CRP levels remained independently associated with composite adverse maternal outcomes.sFlt-1 levels were elevated in patients with PE and severe features. Both sFlt-1 and hs-CRP may predict composite adverse maternal outcomes but do not correlate with each other and differ in perinatal morbidity patterns. These data support the hypothesis that the varied outcomes in PE may result from different pathogenic pathways.Abbreviations: AUC = area under the curve, BMI = body mass index, CI = confidence interval, FullPIERS = preeclampsia integrated estimate of risk, hs-CRP = high-sensitivity C-reactive protein, OR = odds ratio, PE = preeclampsia, sFLt-1 = soluble FMSlike tyrosine kinase-1.

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Can pre‐eclampsia explain higher cesarean rates in the different groups of Robson's classification?

Cited by 13 publications

References 22 publications

Prevalence of Preeclampsia in Brazil: An Integrative Review

Prevalence of Preeclampsia in Brazil: An Integrative Review

Investigating Caesarean Section Practice among Teenage Romanian Mothers Using Modified Robson Ten Group Classification System

Association of sFlt-1 and C-reactive protein with outcomes in severe preeclampsia

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