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Archives of Gynecology and Obstetrics

, Volume 283, Issue 6, pp 1193–1198 | Cite as

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 BodnerEmail author
  • Franz Wierrani
  • Werner Grünberger
  • Barbara Bodner-Adler
Materno-fetal Medicine

Abstract

Objective

The aim of the study was to compare the maternal and neonatal morbidity associated with elective cesarean sections with planned vaginal delivery.

Methods

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.

Results

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).

Conclusion

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.

Keywords

Elective cesarean section Spontaneous onset of labor Planned vaginal delivery Maternal and neonatal morbidity 

Notes

Conflict of interest statement

None.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Klaus Bodner
    • 1
    • 2
    Email author
  • Franz Wierrani
    • 1
  • Werner Grünberger
    • 1
  • Barbara Bodner-Adler
    • 3
  1. 1.Department of Gynecology and ObstetricsHospital RudolfstiftungViennaAustria
  2. 2.Department of Gynecology and Obstetrics, Faculty of Medicine and Health SciencesUnited Arab Emirates UniversityAl AinUnited Arab Emirates
  3. 3.Department of Gynecology and ObstetricsAl Ain HospitalAl AinUnited Arab Emirates

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