Comparison of maternal and fetal complications in elective and emergency cesarean section: a systematic review and meta-analysis

Yang, Xiao-Jing; Sun, Shanshan

doi:10.1007/s00404-017-4445-2

Cited by 103 publications

(90 citation statements)

References 20 publications

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“…Women with assisted delivery and caesarean section face an increased risk of maternal/fetal morbidity and mortality116 and an increased risk of being rehospitalised 117. Women who experience spontaneous vaginal birth with little damage to the perineum have fewer complications postpartum, while assisted vaginal delivery may result in higher incidence of short-term and long-term morbidity 118.…”

Section: Discussionmentioning

confidence: 99%

Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis

et al. 2018

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ObjectiveTo perform a systematic review of the relationships between prenatal exercise and maternal harms including labour/delivery outcomes.DesignSystematic review with random effects meta-analysis and meta-regression.DatasourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies) if they were published in English, Spanish or French and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise, alone [“exercise-only”] or in combination with other intervention components [e.g., dietary; “exercise + co-intervention”]) and outcome (preterm/prelabour rupture of membranes, caesarean section, instrumental delivery, induction of labour, length of labour, vaginal tears, fatigue, injury, musculoskeletal trauma, maternal harms (author defined) and diastasis recti).Results113 studies (n=52 858 women) were included. ‘Moderate’ quality evidence from exercise-only randomised controlled trials (RCTs) indicated a 24% reduction in the odds of instrumental delivery in women who exercised compared with women who did not (20 RCTs, n=3819; OR 0.76, 95% CI 0.63 to 0.92, I 2= 0 %). The remaining outcomes were not associated with exercise. Results from meta-regression did not identify a dose–response relationship between frequency, intensity, duration or volume of exercise and labour and delivery outcomes.Summary/conclusionsPrenatal exercise reduced the odds of instrumental delivery in the general obstetrical population. There was no relationship between prenatal exercise and preterm/prelabour rupture of membranes, caesarean section, induction of labour, length of labour, vaginal tears, fatigue, injury, musculoskeletal trauma, maternal harms and diastasis recti.

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Section: Discussionmentioning

confidence: 99%

Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis

et al. 2018

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“…However, we recommend that such adverse effects should be evaluated if this intervention The burden of postpartum infections at our study site and many settings in sub Saharan Africa is very variable but mostly high (Sway et al, 2019, Chu et al, 2015, Arabshahi and Koohpayezade, 2006, Mangram et al, 1999. Previous studies have shown that mothers who undergo emergency cesarean sections are at a higher risk for SSI compared to those undergoing elective procedures (Yang and Sun, 2017). Mothers that need emergency CS are usually referred from peripheral rural sites, have travelled long distances, not prepared for surgery, with some mothers involved in farming, brought to the hospital straight from their gardens, exposing them to high risk for infections.…”

Section: Discussionmentioning

confidence: 92%

Effectiveness of preoperative bath using Chloroxylenol antiseptic soap on the incidence of post emergency Cesarean section surgical site infection at Mbarara Regional Referral hospital, Uganda: a Randomized Controlled trial

Lukabwe

Kajabwangu

Mugisha

et al. 2020

Preprint

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Introduction: Surgical Site Infections (SSIs) are infections that occur at or near the surgical incision within 30 days of the surgery. SSIs are the commonest form of hospital acquired infections in sub Saharan Africa with estimates between 15%-45%. Cesarean delivery is the single most important risk factor for postpartum infections, carrying a 5 to 20-fold increase in the risk of developing sepsis, with an even higher risk when the operation is an emergency. In sub Saharan Africa, the leading cause of maternal mortality is puerperal sepsis. There is a need for simple interventions that can reduce this burden of SSI in the limited resource settings. Therefore, the purpose of this study was to measure the effectiveness of chloroxylenol in reducing the incidence of post Cesarean section surgical site infections at Mbarara Regional Referral Hospital.Methods: We conducted a single blinded randomized controlled trial at MRRH maternity ward in which women due for CS were randomized into either control or intervention arms. The intervention was a complete body bath with chloroxylenol antiseptic soap before the operation, while the control arm study participants received a standard pre-operative preparation procedures according to the existing ward protocol. All participants were followed up for 30 days and assessed using a standard SSI screening tool.Results: Ninety-six women were randomized, and 48 were assigned to either arm. The overall incidence of SSI was 30.21%. The incidence of SSI was significantly lower in the intervention compared to the control arm, at 6.25% in the intervention arm versus 54.17% in the control arm (p value<0.001). Chloroxylenol bath was protective of SSI with a 90% risk reduction for SSI (95% confidence interval of 67% – 97%).Conclusion: A preoperative bath with chloroxylenol for pregnant mothers is associated with a significantly lower risk of post Cesarean section surgical site infections. Health facilities with a high burden of post SSI should consider adding this simple and effective intervention to the existing infection prevention measures. Clinical Trials.gov registration (NCT03544710)

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“…Labor arrest is a condition that varies from slowerthan-normal progression or complete absence of labor caused by poor cervical ripening despite adequate myometrial contractions (Feinstein et al 2002;Gifford et al 2000;Bardin et al 2016). As labor arrest is the most common indication for emergency cesarean section (ECS), which is associated with increased rates of maternal and fetal morbidities (Yang and Sun 2017), there has been much debate on the relationship between labor arrest and ECS (Gifford et al 2000;Bardin et al 2016;Karaaslan et al 2019). However, predicting the risk of ECS due to labor arrest in the clinical setting is difficult.…”

Section: Introductionmentioning

confidence: 99%

Fetal Biparietal Diameter as a Potential Risk Factor for Emergency Cesarean Section due to Labor Arrest

Shinohara

Amemiya

Takizawa

2020

Tohoku J. Exp. Med.

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Labor arrest is the most common indication for emergency cesarean section (ECS). Increased biparietal diameter (BPD) has been reported as a risk factor for ECS due to labor arrest in different countries, but it is unclear whether this relationship is relevant in Japan. Considering the difference in maternal physique according to race and ethnicity, we retrospectively evaluated the association between ECS due to labor arrest and BPD, measured by ultrasonography < 7 days before term deliveries in Japanese women. BPD is routinely measured in Japan for estimating fetal weight. Information was extracted from obstetric records at the National Hospital Organization Kofu National Hospital between January 2012 and November 2019. Patients with multiple pregnancies, instrumental (forceps or vacuum) delivery, elective cesarean sections, and ECS due to reasons other than labor arrest were excluded. Thus, 2,695 women were included (age, 31.3 ± 6.2 years; pre-pregnancy body mass index, 20.9 ± 3.2 kg/m 2 ), and 1,319 (48.9%) were nulliparous. The incidence of ECS due to labor arrest was 2.4% (64/2,695). Multivariable analysis indicated that BPD was significantly associated with ECS due to labor arrest (adjusted odds ratio, 1.12; 95% confidence interval, 1.04-1.20). The optimal BPD cut-off value for predicting ECS due to labor arrest was 94 mm (area under the curve, 0.61; sensitivity, 53.1%; specificity, 65.1%). Despite the significant association with ECS, BPD is not useful to predict ECS due to labor arrest. Thus, mothers should be encouraged for attempting vaginal deliveries, even in the case of having babies with large fetal BPD.

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Comparison of maternal and fetal complications in elective and emergency cesarean section: a systematic review and meta-analysis

Abstract: Emergency cesarean sections showed significantly more maternal and fetal complications and mortality than elective cesarean sections in this study. Certain plans should be worked out by obstetric practitioners to avoid the post-operative complications.

Cited by 103 publications

References 20 publications

Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis

Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis

Effectiveness of preoperative bath using Chloroxylenol antiseptic soap on the incidence of post emergency Cesarean section surgical site infection at Mbarara Regional Referral hospital, Uganda: a Randomized Controlled trial

Fetal Biparietal Diameter as a Potential Risk Factor for Emergency Cesarean Section due to Labor Arrest

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