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

Amorim, Melânia Maria Ramos; Souza, Alex Sandro Rolland; Katz, Leila

doi:10.1002/14651858.cd009430.pub2

Cited by 34 publications

(30 citation statements)

References 31 publications

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“…Fifteen studies in relation to preeclampsia, chronic or gestational hypertension were included. There were three Cochrane reviews [118][119][120], two RCTs [121,122], a post hoc analysis of an RCT [123], three prospective cohort studies [124][125][126], four retrospective cohort studies [127][128][129][130], and two case control studies [131,132]. A further systematic review was excluded as it did not identify any additional studies not already included [133].…”

Section: Hypertension/preeclampsiamentioning

confidence: 99%

“…Severe maternal morbidity was found to be associated with CS (OR 1.91). Amorim et al [120] also conducted a Cochrane review to compare maternal and neonatal outcomes for women with severe preeclampsia who had a planned CS versus planned vaginal birth. However, this review did not identify any studies for inclusion and had no results to report.…”

Section: Hypertension/preeclampsiamentioning

confidence: 99%

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A systematic scoping review of clinical indications for induction of labour

Coates¹,

Makris²,

Catling³

et al. 2020

PLoS ONE

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Background The proportion of women undergoing induction of labour (IOL) has risen in recent decades, with significant variation within countries and between hospitals. The aim of this study was to review research supporting indications for IOL and determine which indications are supported by evidence and where knowledge gaps exist. Methods A systematic scoping review of quantitative studies of common indications for IOL. For each indication, we included systematic reviews/meta-analyses, randomised controlled trials (RCTs), cohort studies and case control studies that compared maternal and neonatal outcomes for different modes or timing of birth. Studies were identified via the databases PubMed, Maternity and Infant Care, CINAHL, EMBASE, and ClinicalTrials.gov from between April 2008 and November 2019, and also from reference lists of included studies. We identified 2554 abstracts and reviewed 300 full text articles. The quality of included studies was assessed using the RoB 2.0, the ROBINS-I and the ROBIN tool. Results 68 studies were included which related to post-term pregnancy (15), hypertension/preeclampsia (15), diabetes (9), prelabour rupture of membranes (5), twin pregnancy (5), suspected fetal compromise (4), maternal elevated body mass index (BMI) (4), intrahepatic cholestasis of pregnancy (3), suspected macrosomia (3), fetal gastroschisis (2), maternal age (2), and maternal cardiac disease (1). Available evidence supports IOL for women with post-term pregnancy, although the evidence is weak regarding the timing (41 versus 42

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Section: Hypertension/preeclampsiamentioning

confidence: 99%

Section: Hypertension/preeclampsiamentioning

confidence: 99%

A systematic scoping review of clinical indications for induction of labour

Coates¹,

Makris²,

Catling³

et al. 2020

PLoS ONE

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“…No randomized control trials have investigated this topic. 1 Few retrospective studies have investigated rates of labor inductions and neonatal outcomes, by mode of delivery, in early preterm pregnancies complicated by preeclampsia. 2e5 Only two studies have evaluated neonatal outcomes by intended mode of delivery in women with early preterm preeclampsia, but both were singlecenter studies and lacked enough numbers to study rare neonatal outcomes, making it difficult to apply these conclusions to the broader population.…”

mentioning

confidence: 99%

Early preterm preeclampsia outcomes by intended mode of delivery

Coviello

Iqbal

Grantz

et al. 2019

American Journal of Obstetrics and Gynecology

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BACKGROUND: The optimal route of delivery in early-onset preeclampsia before 34 weeks is debated because many clinicians are reluctant to proceed with induction for perceived high risk of failure. OBJECTIVE: Our objective was to investigate labor induction success rates and compare maternal and neonatal outcomes by intended mode of delivery in women with early preterm preeclampsia. STUDY DESIGN: We identified 914 singleton pregnancies with preeclampsia in the Consortium on Safe Labor study for analysis who delivered between 24 0/7 and 33 6/7 weeks. We excluded fetal anomalies, antepartum stillbirth, or spontaneous preterm labor. Maternal and neonatal outcomes were compared between women undergoing induction of labor (n ¼ 460) and planned cesarean delivery (n ¼ 454) and women with successful induction of labor (n ¼ 214) and unsuccessful induction of labor (n ¼ 246). We calculated relative risks and 95% confidence intervals to determine outcomes by Poisson regression model with propensity score adjustment. The calculation of propensity scores considered covariates such as maternal age, gestational age, parity, body mass index, tobacco use, diabetes mellitus, chronic hypertension, hospital type and site, birthweight, history of cesarean delivery, malpresentation/breech, simplified Bishop score, insurance, marital status, and steroid use. RESULTS: Among the 460 women with induction (50%), 47% of deliveries were vaginal. By gestational age, 24 to 27 6/7, 28 to 31 6/7, and 32 to 33 6/7, the induction of labor success rates were 38% (12 of

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“…The in uence of transfer-cesarean section to mother and neonates Termination of pregnancy is the only cure for preeclampsia.Caesarean sections were associated with increased maternal morbidity, raising the risk of haemorrhagic and infectious complications and the rate of postpartum hypertensive crises,and prolonged hospitalization [7][8][9] .Thus,To pregnant with severe preeclampsia,guidelines and medical literature support vaginal delivery if there is no other indication of caesarean sections [10][11][12] .However,the decision regarding mode of delivery is not easy, obstetricians and pregnants often worry about that the maternal and fetal'clinical conditions will worsen during vaginal delivery.Thus,many patients and doctors choose cesarean section directly in clinical.In the present study, a high direct caesarean section rate of almost 66% was found in patients with severe preeclampsia.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Maternal-Fetal Outcomes of Pregnant with Preeclampsia Who Converted to Cesarean Section After A Trial Vaginal Birth

Yan²,

Chen³

2020

Preprint

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Background: At present, most pregnant with preeclampsia choose direct cesarean section. Whether cesarean section after vaginal trial affects the outcome of mother and child and its related risk factorsIt are still unclear. The purpose of this study is to investigate the risk factors and maternal-neonatal outcomes in severe preeclampsia patients who undergo transfer-cesarean section during vaginal labor. Methods: For this retrospective study, patient with severe preeclampsia data from 2015 to 2019 was collected. Study participants were women with severe preeclampsia having a cesarean section during week 34 and 41 of gestation.The population was classified into three groups: patients with severe preeclampsia had cesarean section directly, patients with severe preeclampsia had vaginal deliveries and patients with severe preeclampsia who sufferred from transfer-cesarean section in the vaginal labor. The demographic variables and maternal-fetal outcomes were collected and analyzed. Results: (1) 34%(553/1626) severe preeclampsia had labor induction or natural labor and the ratio of transfer-cesarean section after trial of labor was 39% (216/553) . (2)There was a greater incidence of postpartum haemorrhage (7.7% versus 4.5%),the need for blood transfusion (2.4% versus 0.6%) and more than 7 days of hospitalization (10.4% versus 0.6%) in patients submitted to direct caesarean section compared with vaginal delivery.Apgar score at 5 min <7score and admission of NICU (7.5% versus 2.7%;26.0% versus 18.4%) in the neonates were significantly higher in the direct cesarean section group compared with vaginal delivery,but no difference between direct cesarean section group and transfer cesarean section.(3)When multiple logistic regression analysis was performed,the variables that remained significantly associated with transfer cesarean section were cephalopelvic disproportion (OR ¼ 2.13; 95% CI: 1.43–8.13) and fetal distress (OR ¼ 2.42; 95% CI: 1.76–6.65). Conclusion: Vaginal delivery can be recommended to pregnants with severe preeclampsia as long as there are no contraindications for vaginal delivery. Attempting but failing vaginal delivery would not increase the complications of mother and neonates,but fetal monitoring and labor evaluation should be strengthen during the process of labor.

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

Abstract: AS, Amorim MM. Evidencebased treatment of preeclampsia [Tratamento da pré-eclâmpsia de acordo com as evidências]. Revista

Cited by 34 publications

References 31 publications

A systematic scoping review of clinical indications for induction of labour

A systematic scoping review of clinical indications for induction of labour

Early preterm preeclampsia outcomes by intended mode of delivery

Risk Factors and Maternal-Fetal Outcomes of Pregnant with Preeclampsia Who Converted to Cesarean Section After A Trial Vaginal Birth

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