The increasing cesarean rate globally and what we can do about it

Niino, Yoshiko

doi:10.5582/bst.2011.v5.4.139

Cited by 117 publications

(110 citation statements)

References 17 publications

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“…Our observations are in accordance with their hypothesis, as the indications for emergency CS in both the groups were not statistically significantly different (Table 2). One important point to highlight here is that IOL ''per se'' is done in women who did not have SOL and hence chances of unsuccessful TOLAC and incidence of CS should be expected to be much higher (than SOL), with whatsoever method is used for IOL in these women [4]. Mifepristone stimulates labor as naturally as possible, which can be very beneficial especially in women with prior CS.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, IOL is not only associated with decreased rates of successful vaginal delivery (compared to spontaneous labor) but also with the increased rates of catastrophic complications, e.g., scar dehiscence/rupture uterus, and subsequent fetal death and severe maternal morbidity and mortality [4]. Cochrane systematic review on IOL in women with prior CS states that there is lack of information to decide optimal method for IOL in women with previous CS [5].…”

Section: Introductionmentioning

confidence: 99%

“…This is not only leading to a massive escalation in the cost of the obstetric services but also increasing the incidence of previously rare but catastrophic complications of pregnancy (e.g., cesarean scar pregnancy, morbid adherent placenta, uterine rupture, and feto-maternal morbidity) [2]. In addition, the increase in the number of pregnant women with previous CS is posing severe constraint on the already scarce resources in the developing countries [3].…”

Section: Introductionmentioning

confidence: 99%

“…Even though trial of labor after CS (TOLAC) is a reasonable option in majority of these women [4], still a significant proportion of these women undergo elective repeat CS (ERCS) due to limited options available for IOL in these women, thereby further compounding the dangerous trend of rising rates of CS [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

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A Retrospective Case–Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section

Sharma

Soni

et al. 2015

J Obstet Gynecol India

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Objective To investigate the role of ''mifepristone'' for induction of labor (IOL) in pregnant women with prior cesarean section (CS).Methods In this retrospective study, all pregnant women with prior CS who received oral mifepristone (400 mg) for IOL (as per clear obstetric indications) [group 1] were compared with pregnant women with prior CS who had spontaneous onset of labor (SOL) [group 2], with respect to incidence of vaginal delivery, CS, duration of labor, and various maternal and fetal outcomes. Results During the study period, 72 women received mifepristone (group 1) for IOL and 346 had SOL (group 2). In group 1 after mifepristone administration, 40 (55.6 %) women had labor onset, and 24 (33.3 %) women had cervical ripening (Bishop Score C 8) within 48 h. There were no statistically significant differences with respect to duration of labor (p value: 0.681), mode of delivery (i.e., normal delivery or CS-p value: 0.076 or 0.120, respectively), or maternal (blood loss or scar dehiscence/rupture uterus), or fetal outcomes (NICU admission) compared to women with previous CS with SOL (group 2). However,

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Retrospective Case–Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section

Sharma

Soni

et al. 2015

J Obstet Gynecol India

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“…Rates of cesarean delivery (CD) have increased dramatically in the USA [1], in Italy [2], and throughout the world [3]. Possible reasons include the modern option of patient-choice CD, medicallegal pressures to deliver "un-injured" babies, and an increasing number of medical indications for CD [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

The association between the regular use of risk-based term IOL and improved birth outcomes in an Italian hospital: A retrospective cohort study

Boca¹,

Biffi²,

R³

et al. 2017

Med Res Innov

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Objective: Associations have been recently reported between the regular use of risk-based term labor induction and improvements in birth outcomes. We wanted to study the use of this approach in an Italian hospital. Design: Retrospective Cohort StudySetting: The Mandic Hospital, in Merate, Italy, from March 2009 through July 2010.Population: All pregnant women delivering at term who met study inclusion and exclusion criteria. Methods:The "exposed" group was comprised of women cared for and delivered by providers who regularly offered risk-based term labor induction. The "nonexposed" group was comprised of women cared for and delivered by providers who followed the "expectant management" approach to risk. Prenatal, intrapartum and outcome data for the two cohorts were collected and compared. Main outcome measures:Cesarean delivery rate and weighted Adverse Outcome Index (AOI) Score. Results:The exposed group (n=120), as compared to the non-exposed group (n=159), had a higher induction rate, a lower cesarean rate (1.7% vs. 43.4%, aOR 0.04, CI [0.01-0.22]), and a numerically lower weighted Adverse Outcome Index Score (0.4 vs. 6.1, p=0.61). Two cases of term stillbirth occurred in the non-exposed group. No adverse birth outcome occurred with greater frequency in the exposed group. Conclusion:In this Italian hospital, and consistent with previous studies, exposure to the regular use of risk-based term labor induction was associated with a more favorable set of birth outcomes. Randomised clinical trials are needed to further explore this alternative approach.

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Cesarean Section

Gilson

2015

Small Animal Surgical Emergencies

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The increasing cesarean rate globally and what we can do about it

Cited by 117 publications

References 17 publications

A Retrospective Case–Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section

A Retrospective Case–Control Study Evaluating the Role of Mifepristone for Induction of Labor in Women with Previous Cesarean Section

The association between the regular use of risk-based term IOL and improved birth outcomes in an Italian hospital: A retrospective cohort study

Cesarean Section

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