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

f 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.


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

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