Fetal and Neonatal Morbidity and Mortality Following Delivery After Previous Cesarean

Go, Mitzi; Emeis, Cathy; Guise, Jeanne Marie; Schelonka, Robert L.

doi:10.1016/j.clp.2011.03.001

Cited by 8 publications

(11 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Planned repeat CD and TOLAC each incur important risks to a pregnant or laboring woman, 37, 38 to her fetus or neonate, 9 and to future children. 8, 37 Study results add to prior work showing that a growing share of US women are choosing VBAC out-of-hospital.…”

Section: Commentmentioning

confidence: 99%

“…Increasing numbers of US women seek out-of-hospital birth, 4, 5 including those seeking VBAC. 6, 7 While it is well-established that in-hospital VBAC carries a small but significantly increased risk for neonatal mortality 8, 9 and evidence suggests a small but significant relative increase in intrapartum fetal and neonatal mortality associated with out-of-hospital birth, 10, 11 less is known about neonatal outcomes for out-of-hospital VBAC.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Vaginal birth after cesarean: neonatal outcomes and United States birth setting

Tilden

Cheyney

Guise

et al. 2017

American Journal of Obstetrics and Gynecology

Self Cite

View full text Add to dashboard Cite

Background Women seeking VBAC may find limited in-hospital options. Increasing numbers of US women are delivering by VBAC out-of-hospital. Little is known about neonatal outcomes among those delivering by VBAC in vs. out-of-hospital. Objective(s) To compare neonatal outcomes between women delivering via VBAC in hospital vs. out-of-hospital (home and freestanding birth center). Study Design Retrospective cohort study using 2007-2010 linked US birth and death records to compare singleton, term, vertex, non-anomalous, live born neonates who delivered by VBAC in or out-of-hospital. Descriptive statistics and multivariate regression analyses were conducted to estimate unadjusted, absolute, and relative birth setting risk differences. Stratification by parity and history of vaginal birth examined association between birth setting and each outcome. Sensitivity analyses involving three transfer status scenarios were conducted. Results A small proportion of the total number of US women with a history of cesarean (n = 1,138,813) delivered by VBAC (n = 109,970, 9.65%) with a large majority of these delivering in-hospital (n = 106,823, 97.14%). The proportion of home VBAC births increased from 1.78% to 2.45%. A pattern of increased neonatal morbidity was noted in unadjusted analysis (neonatal seizures, Apgar score <7 or <4, neonatal seizures), with higher morbidity noted in the out-of-hospital setting (neonatal seizures: 23 (0.02%) vs. 6 (0.19%), p <0.001; Apgar score <7: 2859 (2.68%) vs. 139 (4.42%), p <0.001; Apgar score <4: 431 (0.4%) vs. 23 (0.73), p = 0.01). A similar, but non-significant, pattern of increased risk was observed for neonatal death and ventilator support among those born in the out-of-hospital setting. Multivariate regression estimated that neonates born out-of-hospital had higher odds of poor outcomes (neonatal seizures (adjusted odds ratio [aOR] 8.53, 95% confidence interval [CI] 2.87-25.4); Apgar <7 (aOR, 1.62; 95% CI, 1.35-1.96); Apgar <4 (aOR 1.77, CI 1.12-2.79)). While odds of neonatal death (aOR, 2.1; CI 0.73-6.05, p = 0.18) and ventilator support (aOR 1.36, CI 0.75-2.46) appeared to be increased in out-of-hospital settings, findings did not reach statistical significance. Women birthing their second child by VBAC in out-of-hospital settings had higher odds of neonatal morbidity and mortality compared to women of higher parity. Women without a history of vaginal birth prior to out-of-hospital VBAC delivery had higher odds of neonatal morbidity and mortality compared to those with a history of vaginal birth. Sensitivity analyses generated distributions of plausible alternative estimates by outcome Conclusions Fewer than 1 in 10 US women with a prior CD delivered by VBAC in any setting and increasing proportions of these women delivered out-of-hospital. Adverse outcomes were more frequent for neonates born out-of-hospital, with risk concentrated among women birthing their second child and women without a history of vaginal birth. This information urgently signals the need to increase availa...

show abstract

Section: Commentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vaginal birth after cesarean: neonatal outcomes and United States birth setting

Tilden

Cheyney

Guise

et al. 2017

American Journal of Obstetrics and Gynecology

Self Cite

View full text Add to dashboard Cite

show abstract

“…Seuls les articles pour lesquels les résumés étaient disponibles et dont les textes étaient rédigés en langue française ou langue anglaise ont été retenus. Les recommandations des sociétés savantes françaises (Haute Autorité de santé [HAS], www.has-sante.fr/publications) et des sociétés savantes internationales (American College of Obstetricians and Gynecologists [ACOG] [1], Society of Obstetricians and Gynaecologists of Canada [SOGC] [4]), rapport de l'Agency for Healthcare Research and Quality (AHRQ) 2010 [5], les revues récentes sur le sujet [3,6] et la revue de la Cochrane Library 2004 [7] ont été consultées.…”

Section: Matériel Et Méthodesunclassified

“…À ce jour, il n'existe pas d'essai randomisé contrôlé comparant la morbidité et la mortalité néonatales en cas de TVBAC versus une CPAC. Seules des études de cohorte observationnelle sont actuellement disponibles [3]. Il est à noter que dans certaines études, les résultats sont donnés selon le groupe TVBAC ou CPAC et que dans d'autres, on distingue les césariennes qui ont eu lieu après TVBAC.…”

Section: Introductionunclassified

Bénéfices et risques néonataux de la tentative de voie basse comparée à la césarienne programmée en cas d’antécédent de césarienne

López¹,

Patkaï²,

Ayoubi³

et al. 2012

Journal de Gynécologie Obstétrique et Biologie de la Reproducti

View full text Add to dashboard Cite

“…A recent meta‐analysis reported that caesarean delivery is associated with a 23% increase in the risk of stillbirth, compared with vaginal delivery . Adverse neonatal outcomes, such as prematurity and low birthweight, are also more frequent among women with a history of previous caesarean section …”

Section: Introductionmentioning

confidence: 99%

Blood flow to the scarred gravid uterus at 22–24 weeks of gestation

Flo

Widnes

Vårtun

et al. 2013

BJOG

View full text Add to dashboard Cite

Objective To compare uterine artery volume blood flow (Q uta ), vascular resistance (R uta ), pulsatility index (Uta PI), and the fraction of maternal cardiac output (CO) distributed to the uteroplacental circulation in pregnant women with and without a previous caesarean section.Design Cross-sectional observational study.Setting University hospital in Norway.Population Thirty-two pregnant women with previous caesarean section and 32 matched controls.Methods Ultrasonography was used to measure uterine artery diameter and blood flow velocity between 22 +0 and 23 +6 weeks of gestation. Impedance cardiography was used to assess maternal haemodynamics.Main outcome measures Q uta , R uta , Uta PI, and the fraction of maternal CO distributed to the uteroplacental circulation.Results The mean Q uta was 356.26 AE 213.72 ml/minute in cases and 456.41 AE 209.70 ml/minute in controls (P = 0.038). R uta was significantly (P = 0.026) higher among cases compared with controls (0.32 AE 0.20 versus 0.22 AE 0.14 mmHg/ml/minute), but the Uta PI did not differ between the groups (0.93 AE 0.23 versus 0.92 AE 0.47; P = 0.929). The fraction of maternal CO distributed to the uteroplacental circulation was 5.75 AE 3.68% in cases and 8.45 AE 5.02% in controls (P = 0.014).Conclusions Uterine artery volume blood flow and the fraction of maternal cardiac output distributed to the uteroplacental circulation are lower, and uterine vascular resistance (but not Uta PI) is higher, in women with previous caesarean section compared with the control group.

show abstract

Fetal and Neonatal Morbidity and Mortality Following Delivery After Previous Cesarean

Cited by 8 publications

References 36 publications

Vaginal birth after cesarean: neonatal outcomes and United States birth setting

Vaginal birth after cesarean: neonatal outcomes and United States birth setting

Bénéfices et risques néonataux de la tentative de voie basse comparée à la césarienne programmée en cas d’antécédent de césarienne

Blood flow to the scarred gravid uterus at 22–24 weeks of gestation

Contact Info

Product

Resources

About