Planned caesarean section versus planned vaginal delivery for severe preeclampsia

Amorim, Melania; Souza, Alex Sandro Rolland; Katz, Leila; Neto, Carlos Noronha

doi:10.1002/14651858.cd009430

Cited by 6 publications

(6 citation statements)

References 21 publications

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“…9 They found an increased risk of adverse outcomes for women with PEC-S with a cesarean delivery; however, they did not specifically distinguish between women with and without a prolonged labor as was done in the current study.…”

Section: Discussioncontrasting

confidence: 56%

“…9,10 Among women with PEC-S, >80% are diagnosed before delivery. The clinician is then faced with the decision of when and how to proceed with delivery.…”

Section: Introductionmentioning

confidence: 99%

“…The clinician is then faced with the decision of when and how to proceed with delivery. 9 The Working Group on High Blood Pressure in Pregnancy 1 suggests that an induction of labor for PEC-S should be ‘carried out aggressively once the decision for delivery has been made’. They recommend setting clear end points and suggest a 24-h time point for delivery.…”

Section: Introductionmentioning

confidence: 99%

“…They recommend setting clear end points and suggest a 24-h time point for delivery. This is based on expert opinion with limited research evaluating the impact of length of labor or mode of delivery on maternal or neonatal outcomes in women with PEC-S. 9,11 …”

Section: Introductionmentioning

confidence: 99%

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Induction, labor length and mode of delivery: the impact on preeclampsia-related adverse maternal outcomes

et al. 2016

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OBJECTIVE The objectives were to evaluate whether induction, specifically prolonged labor, was associated with adverse maternal outcomes related to preeclampsia with severe features (PEC-S) and whether cesarean affected the rate. STUDY DESIGN This was a retrospective cohort study of women with PEC-S ≥34 weeks who were diagnosed either before planned cesarean or before induction/latent labor. The primary outcome was a composite adverse maternal outcome related to PEC-S. RESULTS The final cohort comprised 193 women (n = 172 with labor and n = 21 with planned cesarean). The prevalence of the outcome was 15.5%. Women exposed to labor did not have a higher rate compared with planned cesarean (16.3% vs 9.5%, P = 0.4). Adjusting for confounders, women with a cesarean after prolonged labor had a 10-fold higher adverse outcome risk compared with women with a planned cesarean (adjusted odds ratio (aOR) 9.7 (1.2 to 78.6), P = 0.03) or with a vaginal delivery <24 h (aOR 9.7 (1.4 to 67.4), P = 0.02). CONCLUSION Prolonged labor and cesarean in labor were both associated with an increase in our outcome.

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Section: Discussioncontrasting

confidence: 56%

“…9,10 Among women with PEC-S, >80% are diagnosed before delivery. The clinician is then faced with the decision of when and how to proceed with delivery.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Induction, labor length and mode of delivery: the impact on preeclampsia-related adverse maternal outcomes

et al. 2016

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“…Interestingly, the increased risk for cardiovascular complications after cesarean section remained after adjusting for preeclampsia. It is possible that although adjusting for preeclampsia and other predictors, an overrepresentation of women with a more severe preeclampsia was present in the cesarean delivery group [32].…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular complications following cesarean section and vaginal delivery: a national population-based study

Larsson

Matsson

Mooe

et al. 2021

The Journal of Maternal-Fetal & Neonatal Medicine

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Introduction: Rates of cesarean section are rising in both developed and developing countries and while pregnancy and cesarean section are established as risk factors for thromboembolism and stroke, large population-based investigations focusing on all types of cardiovascular complication after delivery is missing. The aim was to analyze the risk of severe cardiovascular complications in the post-partum period following delivery by cesarean section. We also had a control group of vaginal deliveries and a reference group with nulliparas. Materials and Methods: This Swedish population-based study used three national registers between 2005 and 2017 and comprised a total of 1 165 684 individuals. Unselected register data was cross-linked and cardiovascular adverse events were identified by ICD diagnosis codes. 140 128 women (209 391 deliveries) were included in the cesarean group and 614 355 women (973 429 deliveries) in the vaginal control group. The reference group comprised 411 201 agematched nulliparous women. The primary analysis was the risk of severe cardiovascular complications within 42 days of cesarean section or vaginal delivery. The secondary analysis evaluated risk factors for cardiovascular complications. Results: In the cesarean section group, 410 (0.20%) had a serious cardiovascular event within 42 days after delivery, and in the vaginal control group the number was 857 (0.09%). The risk of having an adverse cardiovascular event was significantly greater in the cesarean group (OR 2.23, CI 1.98 to 2.51) for all types of cardiovascular events. Risk factors were high BMI, preeclampsia, greater maternal age, tobacco use and acute cesarean delivery. Conclusions: The absolute numbers on severe maternal morbidity after delivery are low. However, since almost half of the world's population are affected and the frequency of elective cesarean section continues to rise, a doubling of the risk for a severe cardiovascular event within 42 days of delivery is important to consider globally.

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Planned caesarean section versus planned vaginal birth for severe pre-eclampsia

Amorim

Souza

Katz

2017

Cochrane Database of Systematic Reviews

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Planned caesarean section versus planned vaginal delivery for severe preeclampsia

Cited by 6 publications

References 21 publications

Induction, labor length and mode of delivery: the impact on preeclampsia-related adverse maternal outcomes

Induction, labor length and mode of delivery: the impact on preeclampsia-related adverse maternal outcomes

Cardiovascular complications following cesarean section and vaginal delivery: a national population-based study

Planned caesarean section versus planned vaginal birth for severe pre-eclampsia

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