Timing of elective repeat cesarean delivery at term and neonatal outcomes: a cost analysis

Robinson, Christopher; Villers, Margaret S.; Johnson, Donna; Simpson, Kit N.

doi:10.1016/j.ajog.2010.03.045

Cited by 44 publications

(36 citation statements)

References 13 publications

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“…The reasons for this are as follows (8)(9)(10)(11)(12)(13)(14). 1-There is less activity of amiloride-sensitive sodium channels in alveolar epithelial cells following cesarean section, leading to reduced fluid clearance.…”

Section: Discussionmentioning

confidence: 99%

High-risk Factors of Respiratory Distress Syndrome in Term Neonates: A Retrospective Case-control Study

2014

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Respiratory distress syndrome (RDS) is one of the most common causes of neonatal respiratory failure and neonatal death. The underlying pathogenesis of RDS involves developmental immaturity of the lungs, leading to inadequate pulmonary surfactant (PS) production. It was previously believed that RDS mainly occurs in premature infants (1); however, with the application of antenatal corticosteroids and delivery room PS, typical and severe RDS in premature infants is now rarely diagnosed. Greater awareness of RDS has led to a more frequent diagnosis in term neonates (2-5). However, the reasons for the occurrence of RDS in term neonates are different from those in premature infants, and remain unclear. This study aimed to investigate the cause of RDS in full-term neonates by a retrospective case-control study, and thus provide a useful reference for its diagnosis and treatment. MATERIAL AND METHODSThis investigation was approved by the ethics committee of the Beijing Military General Hospital. In this retrospective case-control study, the proportion of the case group (RDS patients) and control group (RDS-free patients) was 1:2. The following information was recorded: mode of delivery, birth asphyxia, premature rupture of membranes (PROM), maternal age at pregnancy, pregnancy hypertension disease, gestational glucose intolerance or diabetes, sex, birth weight, a cord around the neck with compression, oligohydramnios, meconium staining of amniotic fluid, severe fetal distress, and placental abruption.From January 2008 to December 2010, a total of 205 full-term newborns with RDS who were admitted to the Department of Neonatology & Neonatal Intensive Care Unit (NICU) (the largest NICU in the world with 350 beds; there are about 8,000 newborn infants admitted to this NICU within one year) at Bayi Children's Hospital, affiliated with the Beijing Military General Hospital of the Beijing Military Command, were assigned to this study. The diagnosis of term neonatal RDS met the following criteria (2-5): (1) full-term neonates (gestational age ≥37 weeks); (2) acute onset; (3) an acute, explicit perinatal triggering insult, such as severe perinatal acquired infection, severe birth asphyxia, meconium aspiration syndrome, or delivery by selective cesarean section; (4) representative clinical manifestations, including progressive respiratory distress occurring shortly after birth, tachypnea, expiratory grunting, nasal flaring, Background: Respiratory distress syndrome (RDS) is a common critical disease in term neonates, but reasons for the occurrence of RDS remains unclear. Aims: This study aimed to investigate the cause of RDS in full-term neonates by a retrospective case-control study. Study Design: Case-control study. Methods: Among the patients admitted to Bayi Children's Hospital between January 2008 and December 2010, a total of 205 full-term neonates with RDS were assigned to the study group, and 410 full-term neonates without RDS were assigned to the control group. Clinical information, including the presence or absence of ...

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Section: Discussionmentioning

confidence: 99%

High-risk Factors of Respiratory Distress Syndrome in Term Neonates: A Retrospective Case-control Study

2014

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“…In the United States, the rate increased from 20.7% in 1996 to 31.8% in 2007, while in the Netherlands, it increased from 8.5% in 1993 to 15.1% in 2007 (Hamilton et al 2006;Robinson et al 2010;Wilmink et al 2010;Kamiya 2013). The increase at general hospitals in Japan has also been quite marked, rising from 9.9% in 1987 to 24.1% in 2011.…”

Section: Introductionmentioning

confidence: 99%

Elective Cesarean Section at 37 Weeks Is Associated with the Higher Risk of Neonatal Complications

Nakashima

Yamanouchi

Sekiya

et al. 2014

Tohoku J. Exp. Med.

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Elective Cesarean section performed before 39 weeks of gestation may be associated with increased risk of neonatal complications. We retrospectively investigated differences in the neonatal complication rate between 684 newborns delivered by elective Cesarean section at 37 weeks of gestation (n = 390) and those delivered by the same procedure at 38 weeks (n = 294) between 2006 and 2012 at our hospital in order to ascertain whether adverse outcomes differ between the groups. Newborns delivered at 37 weeks had a significantly higher incidence of neonatal intensive care unit admission (p = 0.03), adverse respiratory complications (p < 0.01), low birth weight (p < 0.001), and hypoglycemia (p < 0.005) than those delivered at 38 weeks. Compared with normal weight neonates, low birth weight neonates were more likely to have hypoglycemia (p < 0.001). Multivariate logistic regression analysis revealed that an adverse respiratory outcome was independently associated with gestational age (p < 0.01; odds ratio [OR], 3.26; 95% confidence interval [CI], 1.36-7.81), while hypoglycemia was independently associated with birth weight (p < 0.01; OR, 16.34; 95% CI, 7.72-34.56). Respiratory disorders were significantly associated with gestational age even in normal birth weight newborns without any other complications such as hyperbirilubinemia, hypoglycemia or bacterial infections. In conclusion, the incidence of neonatal complications was higher in newborns delivered at 37 weeks of gestation than in those delivered at 38 weeks via elective Cesarean section. Thus, the procedure should be scheduled at 38 weeks to improve neonatal outcomes.

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“…They concluded that there is 2% increased chance of NICU admission for baby who delivered at 38 weeks. 13,25 According to Okeke et al 22.6%, babies needed NICU admission ≤38 weeks, whereas at 39 weeks only 1.8% babies needed NICU admission. 23 But according to Wilmink et al there is only 1% increase in chance of NICU admission at 38-38+6 weeks who undergo elective LSCS.…”

Section: Discussionmentioning

confidence: 99%

Comparison of maternal and neonatal outcome in elective lower segment cesarean section done at 38 and 39 weeks

Sebastian

Ghose

Soundararajan

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Time to perform elective LSCS is a relevant issue related to mother and foetus. LSCS can be done from 37 weeks onwards because foetal lungs mature by then. But foetuses born at 37 weeks of gestation have more risk of developing respiratory problems, transient tachypnoea of new born, hypothermia, hypoglycaemia and NICU admission.The purpose of this study is to find out appropriate gestational age at which elective LSCS can be performed without adverse maternal and neonatal outcome.Methods: This is an observational comparative study done on 209 antenatal women who underwent elective caesarean section from December 2014 to January 2016.Patients were divided into two groups after taking consent. Maternal parameters like formation of lower uterine segment need for blood transfusion. Neonatal parameters like Apgar score, respiratory distress syndrome and NICU admission with indication and duration were analyzed by chi-square test. Gestational Age and Pre-Op Hb and Post-Op Hb were analyzed by independent ‘t’test.Results: In this study 55% of the pregnant women belong to 38 weeks,45% belongs to 39 weeks. The formation of lower uterine segment was statistically significant and the need for blood transfusion was slightly increased at 39 weeks. But there was no significant difference in Apgar score, Respiratory distress, NICU admission comparing both study groups.Conclusions: Elective caesarean section can be done safely at 38 weeks without affecting maternal and perinatal outcome.

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Timing of elective repeat cesarean delivery at term and neonatal outcomes: a cost analysis

Cited by 44 publications

References 13 publications

High-risk Factors of Respiratory Distress Syndrome in Term Neonates: A Retrospective Case-control Study

High-risk Factors of Respiratory Distress Syndrome in Term Neonates: A Retrospective Case-control Study

Elective Cesarean Section at 37 Weeks Is Associated with the Higher Risk of Neonatal Complications

Comparison of maternal and neonatal outcome in elective lower segment cesarean section done at 38 and 39 weeks

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