Influence of the mode of delivery on maternal and neonatal outcomes: a comparison between elective cesarean section and planned vaginal delivery in a low-risk obstetric population
- Klaus BodnerAffiliated withDepartment of Gynecology and Obstetrics, Hospital RudolfstiftungDepartment of Gynecology and Obstetrics, Faculty of Medicine and Health Sciences, United Arab Emirates University Email author
- , Franz WierraniAffiliated withDepartment of Gynecology and Obstetrics, Hospital Rudolfstiftung
- , Werner GrünbergerAffiliated withDepartment of Gynecology and Obstetrics, Hospital Rudolfstiftung
- , Barbara Bodner-AdlerAffiliated withDepartment of Gynecology and Obstetrics, Al Ain Hospital
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The aim of the study was to compare the maternal and neonatal morbidity associated with elective cesarean sections with planned vaginal delivery.
A total of 178 women with elective cesarean section were compared with the next parity- and age-matched women presenting in spontaneous labor. Our analysis was restricted to a sample of low-risk obstetrical women. Maternal and neonatal outcomes were the main outcome variables of interest. Maternal morbidity outcome variables included wound infection, trauma, puerperal febrile morbidity and significant blood loss (>500 ml). Neonatal outcomes were captured by Apgar scores, cord pH as well as the occurrence of neonatal infections.
A significantly higher rate of puerperal febrile morbidity (n = 46 vs. 14, p = 0.0001) and wound infections (n = 16 vs. 2, p = 0.0001) could be detected in the elective cesarean section group. Additionally, a significant blood loss > 500 ml was more than twice as frequent in the cesarean section group (n = 22 vs. 10, p = 0.03) with non-significant lower postpartum hemoglobin levels being observed (10.4 vs. 11.2 g/dL, p > 0.05). A significant increase for the use of iron supplementation (n = 146 vs. 122, p = 0.002), analgesics (n = 168 vs. 60, p = 0.0001) and antibiotics (n = 48 vs. 18, p = 0.0001) could be found in the puerperal period and hospital admission was prolonged in elective cesarean section (6.8 vs. 3.5 days, p = 0.0001). Additionally, problems in breastfeeding occurred more frequently in this group (n = 18 vs. 4, p = 0.002). Neonatal complications were generally low in both the groups with no significant differences being observed (p > 0.05).
The increased maternal morbidity in elective cesarean section included puerperal febrile morbidity, wound infections as well as breastfeeding problems in the postpartum period. Women should be sufficiently counseled regarding the increased risk of these complications.
KeywordsElective cesarean section Spontaneous onset of labor Planned vaginal delivery Maternal and neonatal morbidity
- Influence of the mode of delivery on maternal and neonatal outcomes: a comparison between elective cesarean section and planned vaginal delivery in a low-risk obstetric population
Archives of Gynecology and Obstetrics
Volume 283, Issue 6 , pp 1193-1198
- Cover Date
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- Elective cesarean section
- Spontaneous onset of labor
- Planned vaginal delivery
- Maternal and neonatal morbidity
- Industry Sectors
- Author Affiliations
- 1. Department of Gynecology and Obstetrics, Hospital Rudolfstiftung, Vienna, Austria
- 2. Department of Gynecology and Obstetrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, United Arab Emirates
- 3. Department of Gynecology and Obstetrics, Al Ain Hospital, Al Ain, United Arab Emirates