Neonatal Morbidity After Elective Repeat Cesarean Section and Trial of Labor

Hook, Brenda; Kiwi, Robert; Amini, Saeid B.; Hack, Maureen

doi:10.1097/00006254-199803000-00010

Cited by 60 publications

(101 citation statements)

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“…After screening by titles and abstracts, 308 non-relevant studies were excluded and the full texts of 20 articles were assessed. Of these, four were excluded, the reasons for which are shown in Figure 1; thus, 16 studies were included in the meta-analysis [6,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32].…”

Section: Literature Searchmentioning

confidence: 99%

“…Nine studies [6,20,22,25,[27][28][29][30]32] provided data with respect to uterine rupture during TOL (Figure 2). There was evidence of large heterogeneity among the studies (Q = 26.68, p = 0.001, I 2 = 70.0%), and a random-effects model of analysis was used.…”

Section: Primary Outcomementioning

confidence: 99%

“…Four studies [6,25,27,30] provided data to examine the risk of uterine rupture between women with a successful TOL and ERCD. The risk of uterine rupture with a successful TOL was not significantly higher than with ERCD (Peto OR = 1.945, 95% CI: 0.337 to 11.216, p = 0.457) (Figure 3).…”

Section: Comparison Between Successful Tol and Ercdmentioning

confidence: 99%

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Maternal and neonatal morbidity: repeat Cesarean versus a trial of labour after previous Cesarean delivery

Yang

Sun

2017

CIM

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Maternal and neonatal morbidity: repeat Cesarean versus a trial of labour after previous Cesarean delivery Abstract Purpose: The purpose of this study was to perform a meta-analysis comparing the rates of uterine rupture, and other maternal and neonatal complications, between women who undergo a trial of labour (TOL) after a prior Cesarean delivery and those to undergo elective repeat Cesarean delivery (ERCD).Source: Medline, Cochrane, EMBASE and Google Scholar were searched until May 6, 2015 using the keywords/phrases: trial of labour, Cesarean section, elective, repeat, pregnancy and vaginal birth. Randomized controlled trials (RCTs), two-arm prospective studies, one-arm studies and retrospective studies were included. The primary outcome was uterine rupture.Principal findings: Sixteen studies were included in the meta-analysis. TOL after prior Cesarean delivery was associated with higher odds of uterine rupture as compared with ERCD (Peto odds ratio [OR] = 4.685, 95% confidence interval [CI]: 3.077 to 7.133, p < 0.001). TOL was associated with a higher rate of endometritis, a lower rate of hysterectomy, and a lower rate of respiratory problems in newborns. There were no differences between the groups with respect to neonatal intensive care unit admissions, postpartum hemorrhage, thromboembolic disease, sepsis and neonatal mortality.Conclusions: TOL may be associated with a higher risk of uterine rupture and endometritis, but lower risk of hysterectomy and neonatal respiratory problems than ERCD.

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Section: Literature Searchmentioning

confidence: 99%

Section: Primary Outcomementioning

confidence: 99%

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Maternal and neonatal morbidity: repeat Cesarean versus a trial of labour after previous Cesarean delivery

Yang

Sun

2017

CIM

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“…[6][7][8][9][10][11] TTN results from delayed clearance of fetal lung fluid at birth 12,13 and occurs in isolation or in association with other neonatal respiratory illnesses, such as surfactant deficiency, 14 neonatal pneumonia 14 and persistent pulmonary hypertension of the newborn. 15,16 While TTN is a self-limiting condition, affected infants often undergo evaluation with laboratory testing, chest radiography and close monitoring in a special care nursery (SCN) or neonatal intensive care unit (NICU).…”

Section: Introductionmentioning

confidence: 99%

“…Delivery by cesarean section, especially prior to the onset of labor, is associated with an increased risk of TTN. [7][8][9][10][11][21][22][23][24] Levels of circulating catecholamines are higher in newborns delivered vaginally than in newborns delivered by cesarean section, possibly due to the stimulation of catecholamine release by the stress of labor. 25 Catecholamine levels are lower in infants with TTN than in infants without TTN.…”

Section: Introductionmentioning

confidence: 99%

Inhaled epinephrine for the treatment of transient tachypnea of the newborn

et al. 2008

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Objective: Infants with transient tachypnea of the newborn (TTN) have relatively low levels of epinephrine, which is known to mediate fetal lung fluid absorption. Providing exogenous epinephrine could be a valuable diagnostic and therapeutic intervention for this common condition. Our primary objective was to determine if inhaled racemic epinephrine is safe for the treatment of TTN. Our secondary objective was to determine its efficacy.Study Design: We conducted a randomized, blinded, placebo-controlled pilot trial. Inhaled racemic epinephrine or placebo was administered to 20 newborns with TTN. Physiologic variables of cardiopulmonary function were measured during and after treatment.Result: No infant in either the treatment or control arm experienced an adverse event, including tachycardia or hypertension. We did not detect a difference between the two groups regarding rate of resolution of tachypnea. Conclusion:We did not observe any adverse effects of inhaled racemic epinephrine when administered for the treatment of TTN. Larger studies are necessary to determine efficacy.

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