Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

Hua, Zhifen; Oualja, Fadwa El

doi:10.1186/s12884-019-2604-0

Cited by 4 publications

(1 citation statement)

References 23 publications

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“…This is in line with another study that documented that a high percentage of births via CS are followed by a subsequent birth via the same method without the option of TOLAC (the trial of labor after cesarean) [ 34 ]. Increased maternal age [ 35 ] also contributes to the indication of ERCS (elective repeat CS). Enforcing this practice in Czechia may also have contributed to the increase in the CS rate.…”

Section: Discussionmentioning

confidence: 99%

Has the cesarean epidemic in Czechia been reversed despite fertility postponement?

Fait

Šťastná

Kocourková

et al. 2022

BMC Pregnancy Childbirth

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Background Although the percentage of cesarean sections (CS) in Czechia is below the average of that of other developed countries (23.6%), it still exceeds WHO recommendations (15%). The first aim of the study is to examine the association between a CS birth and the main health factors and sociodemographic characteristics involved, while the second aim is to examine recent trends in the CS rate in Czechia. Methods Anonymized data on all mothers in Czechia for 2018 taken from the National Register of Expectant Mothers was employed. The risk of cesarean delivery for the observed factors was tested via the construction of a binary logistic regression model that allowed for adjustments for all the other covariates in the model. Results Despite all the covariates being found to be statistically significant, it was determined that health factors represented a higher risk of a CS than sociodemographic characteristics. A previous CS was found to increase the risk of its recurrence by 33 times (OR = 32.96, 95% CI 30.95–35.11, p<0.001). The breech position increased the risk of CS by 31 times (OR = 31.03, 95% CI 28.14–34.29, p<0.001). A multiple pregnancy increased the odds of CS six-fold and the use of ART 1.8-fold. Mothers who suffered from diabetes before pregnancy were found to be twice as likely to give birth via CS (OR = 2.14, 95% CI 1.76–2.60, p<0.001), while mothers with gestational diabetes had just 23% higher odds of a CS birth (OR = 1.23, 95% CI 1.16–1.31, p<0.001). Mothers who suffered from hypertension gave birth via CS twice as often as did mothers without such complications (OR = 2.01, 95% CI 1.86–2.21, p<0.001). Conclusions The increasing age of mothers, a significant risk factor for a CS, was found to be independent of other health factors. Accordingly, delayed childbearing is thought to be associated with the increase in the CS rate in Czechia. However, since other factors come into play, further research is needed to assess whether the recent slight decline in the CS rate is not merely a temporal trend.

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Section: Discussionmentioning

confidence: 99%

Has the cesarean epidemic in Czechia been reversed despite fertility postponement?

Fait

Šťastná

Kocourková

et al. 2022

BMC Pregnancy Childbirth

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How two-child policy affects cesarean section in women with advanced maternal age (AMA): using the Robson classification system

Tang,

Zeng,

et al. 2024

BMC Pregnancy Childbirth

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Objectives To study the possible associations between advanced maternal age and cesarean section(CS) under the two child policy. Methods This study used a cohort study from Dongguan People’s Hospital in Guangdong Province, China from 2017 to 2020. The cohort was restricted to women aged ≥ 20 who give birth to babies with a gestational age of > 28 weeks and a weight of > 1000 g. Divide the advanced maternal age (AMA) pregnant women into two age groups: 35–39 years old and 40 years old or older age. We analyzed CS rate and CS contribution using the modified Robson classification system. Frequency of cesarean was determined for each group and compared by using χ 2 and prevalence ratio. Results Overall, 47654 women were included, of which 7924 (16.63%) were between the ages of 35 and 39, and 1529 (3.21%) were aged 40 or older. The total CS rate is 40.64%, with 36.10% for mothers aged 20 to 34, 57.90% for women aged 35 to 40, and 64.75% for women aged 40 or older age. In the AMA groups (n = 9453), Robson group 2’ was the most common, followed by groups 5 and 10. Women at 40 years or older age were 3 times more likely to undergo a cesarean delivery in Robson group 1’, and 1.76 times more likely in group 10. The CS rate in group 2’ were statistically significantly higher in the very AMA group. Conclusions The CS rates increased noticeably with maternal age under the two child policy. Based on the modified Robson classification system, AMA women should pay more attention to primiparous women with single pregnancy, uterine scars, and premature birth in multiple pregnancies.

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Delivery features of pregnant women with a uterine scar

Nikolaeva

Сулима

2023

Sibirskij nauchnyj medicinskij zhurnal

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Vaginal delivery after a Caesarean section remains a controversial topic: there is a lack of reliable data to help doctors and women in labour to determine the best option for delivery during subsequent pregnancy. The review analyzed and summarized the results of the studies devoted to childbirth of pregnant women with scars on the uterus, considered the advantages and disadvantages of vaginal childbirth and repeat Caesarean section, the frequency of complications in the attempt of vaginal childbirth in women with scars on the uterus has been assessed. The modern medical literature available in open sources has been studied: Russian-language scientifc electronic libraries eLibrary and CyberLeninka, Englishlanguage database of medical and biological publications PubMed. It is necessary to consider the data of anamnesis and clinical-instrumental data when choosing the best management tactics of pregnancy and delivery for women with scars on the uterus. Attempting to deliver vaginally helps to reduce maternal and neonatal morbidity, and a large number of studies on this issue should help to reduce the number of unwarranted repeat Caesarean sections. Vaginal delivery after a Caesarean section is an opportunity to avoid severe abdominal surgery and negative consequences associated with repeated Caesarean sections.

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Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

Cited by 4 publications

References 23 publications

Has the cesarean epidemic in Czechia been reversed despite fertility postponement?

Has the cesarean epidemic in Czechia been reversed despite fertility postponement?

How two-child policy affects cesarean section in women with advanced maternal age (AMA): using the Robson classification system

Delivery features of pregnant women with a uterine scar

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