Comparison of Caesarean sections and instrumental deliveries at full cervical dilatation: a retrospective review

Tan, Pei Shan; Tan, Jiajie; Tan, Eng Loy; Tan, Lay Kok

doi:10.11622/smedj.2018040

Cited by 10 publications

(10 citation statements)

References 43 publications

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“…Understandably, babies with large birthweight or head circumference were more likely to encounter cephalo‐pelvic disproportion and be delivered by CSFD than MCI. This was also described in a recent Singaporean cohort …”

Section: Discussionsupporting

confidence: 77%

“…Our study found lower blood loss with CSFD compared to MCI deliveries. The literature is conflicting on this topic; while two recent papers also found CSFD to be associated with lower levels of postpartum haemorrhage, another found the opposite . This discrepancy may result from variations in estimation of blood loss in theatres and birth units, and errors in transcription to the medical record .…”

Section: Discussionmentioning

confidence: 99%

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Risk of preterm birth in the subsequent pregnancy following caesarean section at full cervical dilatation compared with mid‐cavity instrumental delivery

Wang

Kirby

Gibbs

et al. 2019

Aust NZ J Obst Gynaeco

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Background: Expediting delivery in the second stage of labour often involves a choice between a caesarean section at full dilatation or mid-cavity instrumental delivery. Accumulating evidence suggests that the mode of delivery may influence the risk of preterm birth in the subsequent pregnancy. Aims:To directly compare first birth caesarean section at full dilatation with midcavity instrumental delivery for the risk of preterm birth in the subsequent pregnancy (second birth). A further aim was to identify predictive factors associated with these index modes of delivery. Materials and Methods:This is a retrospective cohort study involving three maternity hospitals in western Sydney over the period of 2006-2017. Inclusion criteria were nulliparous women with a singleton term cephalic first birth delivered by caesarean section at full dilatation or mid-cavity instrumental delivery, and whose second birth also occurred under our care. Data were analysed separately for first and second births.Results: There were 425 caesarean section at full dilatation and 874 mid-cavity instrumental cases which met inclusion criteria. The risk of preterm birth in the second birth was 5.7% compared to 3.2%, respectively (risk ratio 1.76; 95% CI 1.04-3.00; P = 0.035). After excluding causes of preterm birth not related to previous mode of delivery, the risk of spontaneous preterm birth was 4.3% compared to 2.0%, respectively (risk ratio 2.18; 1.14-4.19; P = 0.019). Conclusion:Caesarean section at full dilatation is associated with a significantly higher rate of preterm birth in the subsequent pregnancy compared to a mid-cavity instrumental delivery. This should be considered in second-stage mid-cavity decision-making. K E Y W O R D Scaesarean section, full dilatation, instrumental delivery, preterm birth, second stage of labour

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Risk of preterm birth in the subsequent pregnancy following caesarean section at full cervical dilatation compared with mid‐cavity instrumental delivery

Wang

Kirby

Gibbs

et al. 2019

Aust NZ J Obst Gynaeco

View full text Add to dashboard Cite

show abstract

“…We recently published our local experience in this area, specifically looking at dystocia cases . Like the findings made by Muraca et al., babies born by caesarean were larger.…”

mentioning

confidence: 66%

Re: Perinatal and maternal morbidity and mortality among term singletons following midcavity operative vaginal delivery versus caesarean delivery

Tan

et al. 2018

BJOG

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“…Prevalence of maternal complica ons in vacuum delivery was 33.3% (28) and in caesarean was 42.9% (15). Neonatal complica ons in vacuum delivery was 50% (42) and in caesarean was 48.6% (17).…”

Section: Resultsmentioning

confidence: 99%

Operative Deliveries at Full Cervical Dilatation; 'Choosing Between Lesser of Two Evils': A Comparative Study of Morbidities of Vacuum Delivery and Caesarean Section

Aryal¹,

Shrestha²,

Mahato³

2020

Birat J. Health Sci.

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Introduction: Operative delivery at full cervical dilatation can be either a caesarean section or instrumental deliveries. Instrumental deliveries are well debated options for reducing caesarean section rates but they have their own set of maternal and fetal morbidities. CS at full dilatation of cervix is also demanding due to impacted fetal head. Choice between the two depends on the treating obstetrician. Objective: To assess perinatal morbidities between vacuum delivery and caesarean section at full cervical dilatation. Methodology: This is an observational cross-sectional comparative study done for the duration of one year from January to December 2019. Women undergoing vacuum delivery or caesarean section in full cervical dilatation were compared for maternal and neonatal morbidities. Risk factors associated with these morbidities were also assessed. The morbidities in each group were compared using Pearson's chi square test. Likelihood of morbidities in relation to risk factors was calculated using univariate logistic regression. Results: Prevalence of maternal complications in vacuum delivery was 33.3% (28) and in caesarean was 42.9% (15). Neonatal complications in vacuum delivery was 50% (42) and in caesarean was 48.6% (17). Being a referred case (OR=1.14) and a primigravida (OR=1.45) were risk factors for perinatal morbidities in vacuum delivery. Referred cases (OR=1.52), primigravidas (OR=5.90), head station lower than zero (OR=1.26) and birth weight of more than 3500 gms (OR=2.60) were associated with more number of morbidities in caesarean at full cervical dilatation. Conclusion Operative deliveries at full cervical dilatation, either vacuum or CS carry risk of maternal and neonatal morbidities. Obstetrician should make a decision keeping in mind certain risk factors like referred cases, parity, head station, number of pulls, method of delivery of head and fetal weight so that severe morbidities can be prevented.

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Comparison of Caesarean sections and instrumental deliveries at full cervical dilatation: a retrospective review

Cited by 10 publications

References 43 publications

Risk of preterm birth in the subsequent pregnancy following caesarean section at full cervical dilatation compared with mid‐cavity instrumental delivery

Risk of preterm birth in the subsequent pregnancy following caesarean section at full cervical dilatation compared with mid‐cavity instrumental delivery

Re: Perinatal and maternal morbidity and mortality among term singletons following midcavity operative vaginal delivery versus caesarean delivery

Operative Deliveries at Full Cervical Dilatation; 'Choosing Between Lesser of Two Evils': A Comparative Study of Morbidities of Vacuum Delivery and Caesarean Section

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