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)... FL (PRWEB) , ... June 25, 2016 , ... The temporary closing of Bruton Memorial ... Plant City Observer , brings up a new, often overlooked aspect of head lice: the ... closing for fumigation is not a common occurrence, but a necessary one in the event ...
(Date:6/25/2016)... , ... June 25, 2016 , ... First Choice ... States, named Dr. Sesan Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm ... Medical Director of our new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical ...
(Date:6/25/2016)... , ... June 25, 2016 , ... ... and non-athletes recover from injury. Recently, he has implemented orthobiologic procedures as a ... area —Johnson is one of the first doctors to perform the treatment. Orthobiologics ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits of moderation, ... the latter, setting the bar too high can result in disappointment, perhaps even self-loathing. ... toward their goal. , Research from PsychTests.com reveals that behind the ...
(Date:6/24/2016)... ... , ... Those who have experienced traumatic events may suffer from a complex ... as drug or alcohol abuse, as a coping mechanism. To avoid this pain and ... a traumatic event. , Trauma sufferers tend to feel a range of emotions, from ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... DUBLIN , June 23, 2016 ... "Global MEMS Devices Medical Market Analysis 2016 - Forecast to ... The report contains up to date financial ... reliable analysis. Assessment of major trends with potential impact on ... dive analysis of market segmentation which comprises of sub markets, ...
(Date:6/23/2016)... , June 23, 2016 Research ... Pharma News Issue 52" report to their offering. ... in influenza treatment creates a favourable commercial environment for MedImmune ... growing patient base that will serve to drive considerable growth ... vaccine would serve to cap sales considerably, but development is ...
(Date:6/23/2016)... , , , WHEN: ... , , , , LOCATION: , , , Online, with ... , EXPERT PANELISTS:  , , , Frost & Sullivan,s Global Vice ... Senior Industry Analyst, Divyaa Ravishankar and Unmesh Lal, Program Manager , ... industry is witnessing an exceptional era. Several new demand spaces, such ...
Breaking Medicine Technology: