Iatrogenic Fetal Injury

Aburezq, Hisham; Chakrabarty, K

doi:10.1097/01.aog.0000164071.18681.48

Cited by 13 publications

(10 citation statements)

References 11 publications

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“… 11 15 In addition, the onset of labor in cases among women who have undergone previous cesarean is associated with lower cord pH, neonatal sepsis, iatrogenic fetal injury, uterine rupture, and intrapartum fetal death. 13 14 16 In the current study, the risk of adverse neonatal outcomes was not increased among emergent CDs.…”

Section: Discussionmentioning

confidence: 43%

Risk of Emergency Operations, Adverse Maternal and Neonatal Outcomes according to the Planned Gestational Age for Cesarean Delivery

et al. 2018

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BackgroundThe objective of this study was to assess the risk of emergency cesarean deliveries (CDs) and adverse neonatal/maternal outcomes according to the planned gestational age at delivery (GAD) for elective CD.MethodsThe study population consisted of term singleton pregnant women who were booked for elective CD and were subsequently delivered at term by CD, after excluding cases with a trial of labor. The relationship between the planned GAD, risk of emergency CD prior to planned date, and adverse neonatal/maternal outcomes were determined.ResultsThe frequency of emergency CD, adverse neonatal and maternal outcomes were 9.5%, 4.5%, and 5.9%, respectively. The risk of emergency CD prior to the planned delivery date increased significantly according to the planned GAD (5.8% at 37 weeks, 8.2% at 38 weeks, 13.6% at 39 weeks, and 26.7% at 40 weeks or more of planned GAD, P = 0.005). Emergency CD was associated with an increased risk of adverse maternal outcomes, whereas the risk of adverse neonatal outcomes did not differ. In the total study population including both cases with elective and emergency CD, the risk of adverse maternal outcomes did not increase according to the planned GAD, and the risk of adverse neonatal outcomes decreased significantly according to the planned GAD.ConclusionThe risk of emergency CD increased as the planned GAD increased, but the risk of adverse maternal outcomes did not increase and the risk of adverse neonatal outcomes decreased significantly according to the planned GAD in the total study population including elective/emergency CD.

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Section: Discussionmentioning

confidence: 43%

Risk of Emergency Operations, Adverse Maternal and Neonatal Outcomes according to the Planned Gestational Age for Cesarean Delivery

et al. 2018

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“…The reported incidence of iatrogenic fetal trauma during cesarean delivery is 0.1% to 1.9% of births [4]. Several risk factors for fetal injury at the time of the cesarean delivery have been identified through various case reports.…”

Section: Discussionmentioning

confidence: 99%

Health implications resulting from the timing of elective cesarean delivery

Salim

Shalev

2010

Reprod Biol Endocrinol

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BackgroundThe literature is nearly unanimous in recommending elective cesarean delivery at 39 weeks of gestation because of the lower rates of neonatal respiratory complications compared to 38 weeks. However, elective cesarean delivery at 39 weeks or more may have maternal and other fetal consequences compared to delivery at 38 weeks, which are not always addressed in these studies.DiscussionBetween 38 and 39 weeks of gestation, approximately 10% - 14% of women go into spontaneous labor; meaning that a considerable number of women scheduled for an elective cesarean delivery at 39 weeks will deliver earlier in an unscheduled, frequently emergency, cesarean delivery. The incidence of maternal morbidity and mortality is higher among women undergoing non-elective cesarean deliveries than among those undergoing elective ones. Complications may be greater among women after numerous repeat cesarean deliveries and among older women. Other than reducing the frequency of non-elective cesarean deliveries, bringing forward the timing of elective cesarean delivery to 38 weeks, may occasionally prevent intrauterine fetal demise which has been shown to increase with increasing gestational age and to avoid other fetal consequences related to the emergency delivery. All these considerations need to be weighed against the medical and the economic impact of the increase in neonatal morbidity resulting from births at 38 weeks compared to 39 weeks.SummaryUntil prospective randomized trials are conducted, we are unlikely to be able to precisely answer all risk:benefit questions as to the best timing of scheduled elective cesarean delivery. Older women, and women with numerous prior cesarean deliveries, are of particular concern. It is reasonable to inform the pregnant women of the risk of each of the above options and to respect her autonomy and decision-making.

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“…Cesarean deliveries, though performed for fetal benefit in this circumstance, unfortunately do not eliminate the risk to the fetus. 6 7 8 9 10 11 The breech fetus delivered via Cesarean accrues an elevated risk of birth trauma compared with its cephalic-presenting counterpart 6 7 . Several studies have questioned the magnitude of benefit of Cesarean delivery to the premature malpresenting fetus.…”

mentioning

confidence: 99%

External Cephalic Version in Cases of Imminent Delivery at Preterm Gestational Ages: A Prospective Series

Hill

Reed

2019

AJP Rep

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Objective When delivery of a breech fetus is required at a preterm gestational age, Cesarean delivery is often recommended. We performed a prospective patient series to assess the success rate and safety of performing external cephalic version (ECV) procedures on preterm fetuses as an alternative to Cesarean delivery. Study Design We performed a prospective clinical series of patients who required delivery with a malpresenting fetus at a preterm gestational age. Results ECV procedures were successful in singletons 50% of the time. No significant complications or cases of fetal mortality were documented. Conclusion ECV at preterm gestational ages may be an appropriate approach to management in patients requiring delivery. Larger series are needed to further document success rates and risks of the procedure.

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Iatrogenic Fetal Injury

Abstract: Obstetricians should be aware of this potential complication.

Cited by 13 publications

References 11 publications

Risk of Emergency Operations, Adverse Maternal and Neonatal Outcomes according to the Planned Gestational Age for Cesarean Delivery

Risk of Emergency Operations, Adverse Maternal and Neonatal Outcomes according to the Planned Gestational Age for Cesarean Delivery

Health implications resulting from the timing of elective cesarean delivery

External Cephalic Version in Cases of Imminent Delivery at Preterm Gestational Ages: A Prospective Series

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