Navigation Links
Maternal-fetal medicine professionals identify ways to reduce first cesarean
Date:1/24/2014

WASHINGTON--A recently published article, based on a workshop, Preventing the First Cesarean Delivery: Summary of a Joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and the American College of Obstetricians and Gynecologists Workshop, outlines a collaboration of specialists providing obstetrical care in helping to identify opportunities to reduce unnecessary first cesarean deliveries.

With over one-third of pregnancies in the United States being delivered by cesarean and the growing knowledge of morbidities associated with repeat cesarean deliveries, the group thought it was important to convene a workshop to address the concept of preventing the first cesarean.

Brian M. Mercer, M.D., with the Department of Obstetrics and Gynecology at MetroHealth Medical Center Case Western Reserve University in Cleveland, Ohio and George R. Saade, M.D., of the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, were two of the five physicians who authored the article. Mercer is also on the executive committee of the Society for Maternal-Fetal Medicine, and Saade is the chair of the Society's Health Policy Committee.

"Given the risks associated with the initial cesarean and its implications in subsequent pregnancies, the most effective approach to reducing overall morbidities related to cesarean delivery is to avoid the first cesarean," explained Saade. "The implications of a cesarean rate of 30 percent or moresince approximately one in three pregnancies are delivered by cesareanhave significant effects on the medical system as well as on the health of women and children. It is essential to embrace this concern and provide guidance on strategies to lower the primary cesarean rate."

The rise in the rate of cesarean delivery compared to 1995 is due in part to an increase in the frequency of primary cesareans. It is also due to a decline in attempted trials of labor after cesarean. Of U.S. women who require an initial cesarean delivery, over 90 percent will have a subsequent cesarean.

Cesarean increases the risk of maternal complications including intraoperative complications and has clear implications for future pregnancies. Adhesions of uterus, bowel and bladder can result in trauma at surgery, while abnormal placentation and uterine rupture can be catastrophic for both mother and baby.

Workshop participants synthesized available information regarding factors leading to a woman's first cesarean delivery, including obstetric, maternal, and fetal indications for cesarean delivery; labor management and induction practices; and non-medical factors. Participants also reviewed the implications of the first cesarean on future reproductive health, and considered recommendations for practice, opportunities for patient and community education, and potential areas for research.

Guidelines as to when cesarean delivery is appropriate for "failed induction", "arrest of labor progress" or "non-reassuring fetal status" were among the many key points addressed in the workshop to assist in reducing cesarean rates. The need to keep operative vaginal delivery as an acceptable birth method when indicated; and that counseling regarding the effect of cesarean delivery future reproductive health were also highlighted.

At the end of the workshop, the participants concluded that although numerous factors contribute to the primary cesarean rate, the clinician's ability to modify some of these and mitigate others is the first step toward lowering the primary cesarean rate. Education regarding the normal labor course and the implications of first cesarean may allow women and their providers to avoid practices that increase the potential for unneeded first cesarean deliveries.


'/>"/>

Contact: Vicki Bendure
vicki@bendurepr.com
202-374-9259
Society for Maternal-Fetal Medicine
Source:Eurekalert

Related medicine news :

1. Women and Infants Maternal-Fetal Medicine specialist selected for editorial team
2. First targeted nanomedicine to enter human clinical studies
3. Normalizing tumor blood vessels improves delivery of only the smallest nanomedicines
4. AFAR announces the 2012 Hartford Centers of Excellence in Geriatric Medicine awards
5. DNA Testing Finds Allergens, Toxins in Traditional Chinese Medicines
6. Not taking gastroprotective drugs prescribed with anti-inflammatory medicines
7. Nearly 1 in 4 grandparents store prescription medicines where children can easily find them
8. Wilderness Medicine founder offers health tips for summer season
9. Internal medicine physician specialists release policy paper on reforming Medicaid
10. Awards to 5 IU School of Medicine physicians address critical need for geriatricians
11. Annals of Internal Medicine tip sheet for May 8, 2012, online issue
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... , ... June 25, 2016 , ... As a lifelong ... Cum Laude and his M.D from the David Geffen School of Medicine at UCLA. ... to Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai ...
(Date:6/24/2016)... Los Angeles, CA (PRWEB) , ... June 24, 2016 , ... ... plastic surgery procedures that most people are unfamiliar with. The article goes on to ... known procedures, but also many of these less common operations such as calf and ...
(Date:6/24/2016)... Texas (PRWEB) , ... June 24, 2016 , ... ... International Conference and Scientific Sessions in Dallas that it will receive two significant ... of the grants came as PHA marked its 25th anniversary by recognizing patients, ...
(Date:6/24/2016)... Rhinebeck, NY (PRWEB) , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of ... of companies that call for a minimum wage raise to $12 an hour by 2020 ... wage. This will restore the lost value of the minimum wage, assure the wage floor ...
(Date:6/24/2016)... ... June 24, 2016 , ... Puradigm® & Innovative ... has initiated cultivation and processing operations at its production facility, and opened its ... Puradigm is the manufacturer of a complete system of proactive air and surface ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- Research and Markets has announced the addition ... 2022" report to their offering. ... with kidney failure, it replaces the function of kidneys by ... and thus the treatment helps to keep the patient body,s ... Increasing number of ESRD patients & substantial healthcare ...
(Date:6/23/2016)... June 23, 2016  In a startling report released today, ... residents by lacking a comprehensive, proven plan to eliminate prescription opioid ... ranking of how states are tackling the worst drug crisis in ... states – Kentucky , New Mexico ... . Of the 28 failing states, three – ...
(Date:6/23/2016)... , June 23, 2016 ... CAPR ), a biotechnology company focused on ... today announced that patient enrollment in its ongoing ... Duchenne) has exceeded 50% of its 24-patient target. ... in the third quarter of 2016, and to ...
Breaking Medicine Technology: