Method of Delivery and Pregnancy Outcomes in Asia

Lumbiganon, Pisake; Laopaiboon, Malinee; Gülmezoglu, A Metin; Souza, J.P.; Taneepanichskul, Surasak; Ruyan, P.; Attygalle, Deepika; Shrestha, Nisha; Mori, Rintaro; Nguyen, Diem-Tran; Hoang, Thi Bach Yen; Rathavy, Tung; Chuyun, K.; Cheang, Kannitha; Festin, Mario; Udomprasertgul, Venus; Germar, Maria Julieta V; Yanqiu, Gao; Roy, Manidipa; Carroli, Guillermo; Ba-Thike, Katherine; Филатова, Е. Г.; Villar, José

doi:10.1097/01.aoa.0000397123.12461.4e

Cited by 22 publications

(5 citation statements)

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“…There is no way to separate the risks of operative vaginal delivery from the risks associated with vaginal delivery. There was no maternal and neonatal death associated with caesarean section without medical indication preceding labor, and it showed to prevent fetal deaths10 . Unreasonably, in the conclusion the authors report that cesarean section should only be performed if medically indicated, contrary to the results presented.…”

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confidence: 92%

Cesarean section by maternal request

Câmara

Burlá²,

Ferrari

et al. 2016

Rev. Col. Bras. Cir.

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Cesarean section by maternal request is the one performed on a pregnant woman without medical indication and without contraindication to vaginal delivery. There is great controversy over requested cesarean section. Potential risks include complications in subsequent pregnancies, such as uterine rupture, placenta previa and accreta. Potential benefits of requested cesareans include a lower risk of postpartum hemorrhage in the first cesarean and fewer surgical complications compared with vaginal delivery. Cesarean section by request should never be performed before 39 weeks. RESUMO A cesariana a pedido materno é aquela realizada em uma gestante sem indicações médicas e sem contraindicação para tentativa do parto vaginal. Existe grande controvérsia sobre a realização da cesariana a pedido. Riscos potenciais da cesariana a pedido incluem complicações em gravidezes subsequentes, tais como: rotura uterina, placenta prévia e acretismo. Potenciais benefícios da cesariana a pedido englobam um menor risco de hemorragia pós-parto na primeira cesariana e menos complicações cirúrgicas quando comparada ao parto vaginal. A cesariana a pedido jamais deve ser realizada antes de 39 semanas.

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confidence: 92%

Cesarean section by maternal request

Câmara

Burlá²,

Ferrari

et al. 2016

Rev. Col. Bras. Cir.

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“…Many Chinese people think labor pain is normal which is difficult to be avoided for parturient women especially nulliparous, so they choose CD. Under the policy of one-child family taking effect from 1979, wrong cognitions on delivery were prevalent in China, for example they thought the damage caused by episiotomy and that caused by CD were the same, CD might be less likely to affect the quality of sexual life than vaginal birth [13] , and giving birth by selecting a particular date may be more safe [14] . The relative medical indications of CD widely vary all over China, such as pregnancy with severe shortsightedness of eyes, pregnancy by assisted reproduction techniques, primipara more than 35 years old [7,15,16] .…”

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confidence: 99%

The initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective studyThe initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective study

Zhao¹,

Gao²,

Sun³

et al. 2020

Preprint

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Background No Pain Labor ＆Delivery (NPLD) is a nongovernmental project to increase access to safe neuraxial analgesia through specialized training. This study explores the change is overall cesarean delivery (CD) and maternal request CD(MRCD) rate in our hospital after the initiation of neuraxial analgesia service. Methods The neuraxial labor analgesia（NA） was initiated in May 1st 2015 by the help of NPLD. Since then, the application of NA became a routine operation in our hospital, and every parturient can choose to use NA or not according to her own requirement. The monthly rates of NA, CD, MRCD, multiparous women, intrapartum CD, episiotomy, postpartum hemorrhage (PPH), operative vaginal delivery and neonatal asphyxia of vaginal delivery were analyzed from May 1st 2015 to April 30th 2016. Results The rate of NA in our hospital was getting increasingly higher from 26.1% in May 2015 to 44.6% in April 2016 (p<0.001); the rate of CD was decreased from 50.4% in May 2015 to 36.3% in April 2016 ( p<0.001); the rate of MRCD was decreased from 10.8% in May 2015 to 5.7% in April 2016 (p<0.001), but the rate of multiparous women had no change (p＞0.05). There was a negative correlation between the rate of NA and that of overall CD, r=-0.803 (95%CI[-0.951, -0.642], p=0.002), and also a negative correlation between the utilization rate of NA and that of MRCD, r=-0.790 (95%CI[-0.971, -0.497], p=0.004). The rates of episiotomy, PPH, operative vaginal delivery and neonatal asphyxia in women underwent vaginal delivery as well as the rates of intrapartum CD, neonatal asphyxia, and PPH in women underwent CD remained unchanged from May 1st 2015 to April 30th 2016. Conclusions: Our study shows that the rates of CD and MRCD in our department significantly were decreased over a year period (2015. 05.01~2016. 04.30), which may be due to the increasing use of NA during vaginal delivery by the help of NPLD. Key Words: Neuraxial Labor Analgesia; Cesarean Delivery; Maternal Request Cesarean Delivery

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“…The monitoring system covered 326 urban or rural areas in 30 provinces in China and collected data on more than 1.2 million births each year from 441 hospitals (of these, three hospitals stopped collecting data after 2012), accounting for approximately 8% of all births in China. The collection methods used were the same as those recommended by the World Health Organization (WHO) in the global survey of maternal and perinatal health to record information regarding maternal near-misses and foetal outcomes in monitoring hospitals [25]. The NMNMSS selected two health facilities (or one hospital if only one was available) with more than 1,000 births per year in each sampling urban area or rural county.…”

Section: Data Sourcesmentioning

confidence: 99%

The incidence, associated factors and adverse maternal and perinatal outcomes of uterine rupture among vaginal births after caesarean section: An observational study from the National Maternal Near-Miss Surveillance System in China

Zhou

Chen

et al. 2023

Preprint

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Background The most serious problem during vaginal birth after caesarean section (VBAC) is the risk of uterine rupture but there is controversy regarding important related factors. With the relaxation of birth policy in China, the maternal and perinatal outcomes after uterine rupture during VBAC are a societal concern. The lack of any large-scale study of uterine rupture during VBAC in China underscores the need for more research evidence. Methods We studied singleton pregnant women with VBAC from 2012 to 2019 registered in China’s National Maternal Near-Miss Surveillance System (NMNMSS). First, we calculated the incidence of uterine rupture during VBAC. Second, using a logistic regression model with weighting for the sampling distribution of the population and clustering of births within hospitals, we examined the association of sociodemographic and obstetric characteristics and maternal diseases with uterine rupture during VBAC. With multivariable logistic regression, adjusted odds ratio were estimated using two models. Finally, we compared the risk of adverse maternal and perinatal outcomes in women with and without uterine rupture during VBAC. Results This study included 155774 singleton pregnant women with VBAC, and the incidence of uterine rupture was 0.23%. Characteristics associated with the increased risk of uterine rupture during VBAC included two (aOR = 1.70; 95% CI: 1.06–2.73) and three or more (aOR = 2.59; 95% CI: 0.54–12.44) previous caesarean sections, delivery at 42 weeks or later (aOR = 2.62; 95% CI: 1.58–4.35), and foetal birthweight greater than 4000 g (aOR = 1.93; 95% CI: 1.30–2.87). Compared with those without these conditions, the risk of uterine rupture during VBAC among women with amniotic fluid embolism, severe anaemia, placenta accreta spectrum, placental abruption, preeclampsia or eclampsia, and mild anaemia was 25.7-fold, 15.89-fold, 4.17-fold, 3.96-fold, and 2.49-fold higher, respectively. The incidence of adverse maternal outcomes during VBAC was higher in women with uterine rupture than in women without. Conclusion The incidence of uterine rupture during VBAC is comparable between China and some developed countries. In the clinical medical practice of obstetrics, it is necessary to be vigilant to factors associated with uterine rupture during VBAC and identify uterine rupture as soon as possible to improve maternal and perinatal outcomes.

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Method of Delivery and Pregnancy Outcomes in Asia

Cited by 22 publications

References 0 publications

Cesarean section by maternal request

Cesarean section by maternal request

The initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective studyThe initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective study

The incidence, associated factors and adverse maternal and perinatal outcomes of uterine rupture among vaginal births after caesarean section: An observational study from the National Maternal Near-Miss Surveillance System in China

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