Prevention of the First Cesarean Delivery: The Role of Operative Vaginal Delivery

Gei, Alfredo F.

doi:10.1053/j.semperi.2012.04.021

Cited by 36 publications

(43 citation statements)

References 54 publications

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“…44 En caso de enfrentar una emergencia obstétrica en la fase expulsiva, los médicos deben saber manejar exitosamente el parto instrumental (fórceps o ventosa) como alternativa de la cesárea. 18,45,46 En los últimos años, esta práctica se ha perdido entre ginecobstetras, quienes utilizan preferentemente la cesárea para la resolución del parto.…”

Section: Recomendacionesunclassified

Características sociodemográficas y reproductivas asociadas con el aumento de cesáreas en México

et al. 2013

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Objetivo. Describir la tendencia de la cesárea en México y su asociación con características sociodemográficas y reproductivas. Material y métodos. Con base en Encuestas Nacionales de Salud 2000, 2006 y 2012, se analizó información de cesáreas en mujeres. Se utilizó un modelo de regresión logística multivariado en 2012. Resultados. Se identificó un incremento de 50.3% de la operación cesárea a nivel nacional en el periodo de 2000 a 2012. Las mujeres con mayor posibilidad de tener una cesárea fueron las que se atendieron en el sector privado (RM=2.84, 95%IC:2.15- 3.74). Al asociar la edad y la paridad se observan los riesgos más altos en primíparas de 12 a 19 y de 35 o más años (RM=6.02, 95%IC:1.24-29.26 y RM=5.20, 95%IC:2.41-11.21, respectivamente). Conclusiones. Se proponen algunas recomendaciones encaminadas a revertir el incremento de esta práctica clínica, sobre todo en aquellos casos donde no hay una indicación precisa para su realización.

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Section: Recomendacionesunclassified

Características sociodemográficas y reproductivas asociadas con el aumento de cesáreas en México

et al. 2013

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“…3 5-7 In some circumstances, a caesarean section (CS) is the better option, although second stage caesarean is technically difficult and has important implications for subsequent deliveries. [8][9][10] The decision when to intervene, where to deliver, which instrument to use, when to abandon the chosen instrument and whether to seek senior support are challenging elements of OVD. 5 Doctors in training rely primarily on senior obstetricians to support their learning needs in terms of decision-making, and on the acquisition of technical and non-technical skills on the labour ward.…”

Section: Introductionmentioning

confidence: 99%

A prospective cohort study of the morbidity associated with operative vaginal deliveries performed by day and at night

et al. 2014

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ObjectiveTo evaluate maternal and neonatal outcomes associated with operative vaginal deliveries (OVDs) performed by day and at night.DesignProspective cohort study.SettingUrban maternity unit in Ireland with off-site consultant staff at night.PopulationAll nulliparous women requiring an OVD with a term singleton fetus in a cephalic presentation from February to November 2013.MethodsDelivery outcomes were compared for women who delivered by day (08:00–19:59) or at night (20:00–07:59).Main outcome measuresThe main outcomes included postpartum haemorrhage (PPH), anal sphincter tear and neonatal unit admission. Procedural factors included operator grade, sequential use of instruments and caesarean section.ResultsOf the 597 women who required an OVD, 296 (50%) delivered at night. Choice of instrument, place of delivery, sequential use of instruments and caesarean section did not differ significantly in relation to time of birth. Mid-grade operators performed less OVDs by day than at night, OR 0.60 (95% CI 0.43 to 0.83), and a consultant supervisor was more frequently present by day, OR 2.26 (95% CI 1.05 to 4.83). Shoulder dystocia occurred more commonly by day, OR 2.57 (95% CI 1.05 to 6.28). The incidence of PPH, anal sphincter tears, neonatal unit admission, fetal acidosis and neonatal trauma was similar by day and at night. The mean decision to delivery intervals were 12.0 and 12.6 min, respectively.ConclusionsThere was no evidence of an association between time of OVD and adverse perinatal outcomes despite off-site consultant obstetric support at night.

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“…Caesarean section in the second stage of labour is associated with high rates of maternal and fetal morbidity [3,4,9]. Although caesarean section rates increase worldwide, operative vaginal delivery (OVD) rates decline; the USA has some of the lowest OVD rates amongst developed countries [10]. It is clear that well conducted rotational vaginal deliveries may not only reduce the caesarean section rate but are also associated with decreased maternal morbidity without any adverse effect on neonatal outcomes compared with pEMCS [10,11].…”

Section: Why Is Advanced Operative Obstetrics Still Important?mentioning

confidence: 99%

“…Although caesarean section rates increase worldwide, operative vaginal delivery (OVD) rates decline; the USA has some of the lowest OVD rates amongst developed countries [10]. It is clear that well conducted rotational vaginal deliveries may not only reduce the caesarean section rate but are also associated with decreased maternal morbidity without any adverse effect on neonatal outcomes compared with pEMCS [10,11]. We and others have previously proposed that there is still an important role for advanced operative obstetric deliveries in modern obstetric practice, with a need for good-quality holistic training programmes on how to best perform such deliveries [12].…”

Section: Why Is Advanced Operative Obstetrics Still Important?mentioning

confidence: 99%

“…The professional endorsement of rotational vaginal delivery is fundamental to promote and improve the general acceptance of assisted deliveries and facilitate the societal discourse to reduce caesarean section rates [10]. Low rotational vaginal delivery numbers may preclude trainees from acquiring adequate experience and challenge experienced practitioners to maintain proficiency [42].…”

Section: Trainingmentioning

confidence: 99%

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Does advanced operative obstetrics still have a place in contemporary practice?

Tempest

Navaratnam

Hapangama

2015

Current Opinion in Obstetrics &Amp; Gynecology

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There is a need for evidence-based guidelines, including standardized documentation of these advanced procedures. Training strategies for junior practitioners to acquire these skills and for experienced practitioners to maintain and disseminate their skills should be prioritized. The safety of rotational delivery methods versus primary caesarean section is likely to prove difficult to assess directly, in the context of a randomized controlled trial, but may be approximated via a national prospective audit.

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Prevention of the First Cesarean Delivery: The Role of Operative Vaginal Delivery

Cited by 36 publications

References 54 publications

Características sociodemográficas y reproductivas asociadas con el aumento de cesáreas en México

Características sociodemográficas y reproductivas asociadas con el aumento de cesáreas en México

A prospective cohort study of the morbidity associated with operative vaginal deliveries performed by day and at night

Does advanced operative obstetrics still have a place in contemporary practice?

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