Navigation Links
Patience during stalled labor can avoid many C-sections, UCSF study shows

Pregnant women whose labor stalls while in the active phase of childbirth can reduce health risks to themselves and their infants by waiting out the delivery process for an extra two hours, according to a new study by researchers at the University of California, San Francisco.

By doing so, obstetricians could eliminate more than 130,000 cesarean deliveries the more dangerous and expensive surgical approach per year in the United States, the researchers conclude.

The study examined the health outcomes of 1,014 pregnancies that involved active-phase arrest two or more hours without cervical dilation during active labor and found that one-third of the women achieved a normal delivery without harm to themselves or their child, with the rest proceeding with a cesarean delivery.

The findings appear in the November, 2008 issue of Obstetrics and Gynecology, the official journal of the American College of Obstetricians and Gynecologists (ACOG).

While ACOG already recommends waiting at least two hours with adequate contractions in the setting of no progress in active labor, it is routine practice in many clinical settings to proceed with a cesarean for "lack of progress" before those ACOG criteria have been met, according to Aaron Caughey, MD, PhD, an associate professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, and senior author on the paper.

"One third of all first-time cesareans are performed due to active-phase arrest during labor, which contributes to approximately 400,000 surgical births per year," said Caughey, who is affiliated with the UCSF National Center of Excellence in Women's Health. "In our study, we found that just by being patient, one third of those women could have avoided the more dangerous and costly surgical approach."

The cesarean delivery rate reached an all-time high in 2006 of 31.1 percent of all deliveries, according to the UCSF study. Arrest in the active phase of labor has been previously shown to raise the risk of cesarean delivery between four- and six-fold.

"Cesarean delivery is associated with significantly increased risk of maternal hemorrhage, requiring a blood transfusion, and postpartum infection," Caughey said. "After a cesarean, women also have a higher risk in future pregnancies of experiencing abnormal placental location, surgical complications, and uterine rupture."

The ten-year study identified all women who experienced what is known as active-phase arrest during their delivery at UCSF from 1991 to 2001. The study only included women with live, singleton deliveries who were delivered full-term.

The researchers examined maternal outcomes such as maternal infection, endomyometritis, postpartum hemorrhage and the need for blood transfusions. It also examined the infant's Apgar score, rates of infection and frequency of admission to the neonatal intensive care unit, among other health indicators.

The study found an increased risk of maternal health complications in the group that underwent cesarean deliveries, including postpartum hemorrhage, severe postpartum hemorrhage and infections such as chorioamnionitis and endomyometritis, but found no significant difference in the health outcomes of the infants.

It concluded that efforts to continue with a normal delivery can reduce the maternal risks associated with cesarean delivery, without a significant difference in the health risk to the infant.

"Given the extensive data on the risk of cesarean deliveries, both during the procedure and for later births, prevention of the first cesarean delivery should be given high priority," Caughey said.


Contact: Kristen Bole
University of California - San Francisco

Related medicine news :

1. Excess Weight Gain During Pregnancy a Risk to Mother and Child
2. Survey Reveals Heartburn Sufferers Experience More Heartburn During the Holidays
3. Susan Lark, MD Offers 5 Tips for Managing Stress During Tough Economic Times
4. Uroplasty Reports Continued Progress During Second Quarter of Fiscal 2009
5. ING Promotes Physical and Fiscal Fitness During ING New York City Marathon 2008
6. Guardian Survey: More Than Half of Small Business Employers Who Offer Benefits Encounter Challenges During Open Enrollment Season
7. Florida Governor Issues Proclamation During National Healthcare Quality Week
8. Even During Financial Crisis Investing in Wellness is Good Business
9. Supporting Susan G. Komen for the Cure(R) During National Breast Cancer Awareness Month
10. Mrs. United States Breaks the Silence During Mental Illness Awareness Week
11. Adolescent insomnia linked to depression and substance abuse during adolescence and young adulthood
Post Your Comments:
(Date:10/13/2015)... ... 13, 2015 , ... According to an article published October 5th ... who successfully lose weight with a bariatric procedure are much less likely to develop ... notes that anywhere from 40 to 50 percent of all endometrial cancer cases are ...
(Date:10/13/2015)... , ... October 13, 2015 , ... Symposium Chairman, Dr. ... 19th annual Dallas Cosmetic Symposium to be held March 2nd and 3rd, 2016. The ... afterwards, draws plastic surgeons and cosmetic physicians from around the world. , Key topics ...
(Date:10/13/2015)... ... October 13, 2015 , ... ... unique private messaging application, announced today a significant contract that will provide its ... Independence plans to build on the growing success of its Relay program, IBX ...
(Date:10/13/2015)... ... ... NavaFit Inc. today announced the launch of its NavaFit app for iPhone® ... fitness & sporting events, and stay motivated. Users can download the apps ... to get more serious about fitness and wellness, individuals are constantly looking for new ...
(Date:10/13/2015)... ... 2015 , ... Protein is essential to good health. You need it to ... how much protein does the average man need in order to stay healthy? ... 2015 issue of Harvard Men's Health Watch . Most Americans get about 15% ...
Breaking Medicine News(10 mins):
(Date:10/13/2015)... Calif. , Oct. 13, 2015  Asterias ... agreement with the UK-based Cell Therapy Catapult to ... AST-VAC2, Asterias, allogeneic dendritic cell immunotherapy. Under the ... scale manufacturing processes for AST-VAC2 to support advanced ... --> --> The ...
(Date:10/12/2015)... Apheresis is an invasive process that involves the ... components from whole blood. In this procedure, the blood of ... machine or a blood cell separator. The apheresis equipment spins ... components. A selected part of the blood is removed, and ... patient. It involves the use of devices and disposables along ...
(Date:10/12/2015)... 12, 2015  The Pharmacy Compounding Accreditation Board ... Pharmacy in Costa Mesa , ... the pharmacy,s commitment to meeting and/or exceeding national ... --> --> ... --> --> Harbor Compounding ...
Breaking Medicine Technology: