Skip header and navigation

Refine By

5 records – page 1 of 1.

Can Caesarean section improve child and maternal health? The case of breech babies.

https://arctichealth.org/en/permalink/ahliterature277751
Source
J Health Econ. 2015 Jan;39:289-302
Publication Type
Article
Date
Jan-2015
Author
Vibeke Myrup Jensen
Miriam Wüst
Source
J Health Econ. 2015 Jan;39:289-302
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Adult
Apgar score
Breech Presentation - surgery
Cesarean Section - statistics & numerical data
Denmark - epidemiology
Female
Humans
Infant
Infant Health - statistics & numerical data
Infant, Newborn
Male
Maternal Health - statistics & numerical data
Pregnancy
Abstract
This paper examines the health effects of Caesarean section (CS) for children and their mothers. We use exogenous variation in the probability of CS in a fuzzy regression discontinuity design. Using administrative Danish data, we exploit an information shock for obstetricians that sharply altered CS rates for breech babies. We find that CS decreases the child's probability of having a low APGAR score and the number of family doctor visits in the first year of life. We find no significant effects for severe neonatal morbidity or hospitalizations. While mothers are hospitalized longer after birth, we find no effects of CS for maternal post-birth complications or infections. Although the change in mode of delivery for the marginal breech babies increases direct costs, the health benefits show that CS is the safest option for these children.
PubMed ID
25179865 View in PubMed
Less detail

Consequences of the Term Breech Trial in Denmark.

https://arctichealth.org/en/permalink/ahliterature135460
Source
Acta Obstet Gynecol Scand. 2011 Jul;90(7):767-71
Publication Type
Article
Date
Jul-2011
Author
Julie E Hartnack Tharin
Steen Rasmussen
Lone Krebs
Author Affiliation
Department of Obstetrics and Gynecology, Holbaek Hospital, University of Copenhagen, Copenhagen, Denmark. julie_hartnack@hotmail.com
Source
Acta Obstet Gynecol Scand. 2011 Jul;90(7):767-71
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adult
Breech Presentation - surgery - therapy
Cesarean Section - adverse effects - statistics & numerical data
Clinical Trials as Topic
Cohort Studies
Denmark
Female
Follow-Up Studies
Humans
Infant Mortality - trends
Infant, Newborn
Natural Childbirth - statistics & numerical data
Pregnancy
Pregnancy outcome
Publications
Registries
Retrospective Studies
Risk assessment
Safety Management
Term Birth
Treatment Outcome
Young Adult
Abstract
To analyze the consequences of the handling of breech presentation in Denmark after publication of the Term Breech Trial (TBT).
Population-based retrospective cohort study.
Data from the National Birth Registry and discharge letters from cases with perinatal death. Population. Singleton breech fetuses at term and alive at onset of labor delivered between 1997 and 2008 (n=23 789).
Outcomes before and after publication of TBT were compared and analyzed by planned mode of delivery.
Cesarean section, intrapartum or early neonatal mortality in infants without lethal congenital malformations, Apgar score = 6 at five minutes and admittance to neonatal intensive care unit (NICU) for four days or more.
The rate of cesarean section increased from 79.6 to 94.2%. Intrapartum or early neonatal mortality was reduced from 0.13 to 0.05%[relative risk (RR) 0.38 (95% confidence intervals (CI) 0.15-0.98)]. The incidence of low Apgar scores declined from 1.0 to 0.6%[RR 0.83 (95%CI 0.73-0.95)] and admission to NICU from 4.2 to 3.2%[RR 0.92 (95%CI 0.87-0.97)]. Planned vaginal delivery was associated with an increased risk of mortality, low Apgar score and admission to NICU throughout the period.
Reduction in the rate of vaginal delivery was correlated with a significant reduction in rates of intrapartum or early neonatal mortality and morbidity, but at a much lower level than reported in the Term Breech Trial. The lower rate of vaginal delivery, indicating a strict selection of women, did not reduce the relative risks of complications during a planned vaginal delivery.
Notes
Comment In: J Obstet Gynaecol Can. 2012 Apr;34(4):318-922472329
PubMed ID
21476999 View in PubMed
Less detail

Influence of mode of delivery on neonatal mortality in the second twin, at and before term.

https://arctichealth.org/en/permalink/ahliterature91067
Source
BJOG. 2008 Nov;115(12):1512-7
Publication Type
Article
Date
Nov-2008
Author
Herbst A.
Källén K.
Author Affiliation
Department of Obstetrics and Gynaecology, Clinical Sciences, Lund University, Lund, Sweden. andreas.herbst@med.lu.se
Source
BJOG. 2008 Nov;115(12):1512-7
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Breech Presentation - surgery
Cesarean Section - mortality
Delivery, Obstetric - mortality
Female
Gestational Age
Humans
Infant mortality
Infant, Newborn
Infant, Premature
Maternal Age
Odds Ratio
Parity
Pregnancy
Pregnancy outcome
Sweden
Term Birth
Twins
Abstract
DESIGN: To study the association between mode of delivery and neonatal mortality in second twins. To study the association between caesarean delivery and mortality with minimum bias of the indication for the operation, we wanted to compare the outcome of second twins delivered by caesarean due to breech presentation of the sibling with vaginally delivered second twins in uncomplicated pregnancies. SETTING: Sweden, 1980-2004. POPULATION: Twins born during 1980-2004 were identified from the Swedish Medical Birth Registry. Twin pairs delivered by caesarean due to breech presentation of the first twin, and vaginally delivered twins with the first twin in cephalic presentation were included. Pregnancies with antepartum complications were excluded. METHODS: Odds ratios and 95% CI were calculated using multiple logistic regression analyses, adjusting for year of birth, maternal age, parity and gestational age. MAIN OUTCOME MEASURES: Neonatal mortality. RESULTS: Compared with second-born twins delivered vaginally, second-born twins delivered by caesarean (for breech presentation of the sibling) had a lower risk of neonatal death (adjusted OR 0.40; 95% CI 0.19-0.83). The decreased risk after caesarean delivery was significant for births before 34 weeks (2.1 versus 9.0%; adjusted OR 0.40; 95% CI 0.17-0.95). After 34 weeks, neonatal mortality was low in both groups (0.1 and 0.2%, respectively), and the difference was not statistically significant (adjusted OR 0.42; 95% CI 0.10-1.79). CONCLUSIONS: Neonatal mortality is lower for the second twin after caesarean delivery at birth before 34 weeks. At term, mortality is low irrespective of delivery mode.
PubMed ID
19035987 View in PubMed
Less detail

Survey on uterine closure and other techniques for Caesarean section among Quebec's obstetrician-gynaecologists.

https://arctichealth.org/en/permalink/ahliterature114028
Source
J Obstet Gynaecol Can. 2013 Apr;35(4):329-33
Publication Type
Article
Date
Apr-2013
Author
Suzanne Demers
Stéphanie Roberge
Yamal A Afiuni
Nils Chaillet
Isabelle Girard
Emmanuel Bujold
Author Affiliation
Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Quebec City QC.
Source
J Obstet Gynaecol Can. 2013 Apr;35(4):329-33
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Breech Presentation - surgery
Cesarean Section - methods
Female
Gravidity
Humans
Obstetrics - methods
Pregnancy
Quebec
Questionnaires
Time Factors
Uterus - surgery
Abstract
To evaluate the preferred types of uterine closure at Caesarean section among Quebec's obstetrician-gynaecologists.
An anonymous survey with multiple-choice and open questions was sent by email to all members of the Association des Obstétriciens-Gynécologues du Québec in clinical practice. The primary response of interest was the type of uterine closure that would be favoured for a primigravida undergoing an elective CS at term for a breech fetus. Secondary responses of interest included type of uterine closure for CS performed for other indications, and methods of closure for the bladder flap, parietal peritoneum, rectus abdominis muscle, subcutaneous tissue, and skin. Results were stratified according to the number of years in practice.
Of 454 persons targeted, 176 (39%) responded. Responders were more likely to have fewer years in practice than the targeted population in general. The closures for a primigravida undergoing an elective CS at term for a breech presentation were, in order of preference: (1) a double-layer closure combining a first locked layer and an imbricating second layer (61%), (2) a double-layer closure combining a first unlocked layer and an imbricating second layer (28%), (3) a locked single layer (5%), (4) an unlocked single layer (5%), and (5) other techniques (1%). A locked single-layer closure was more frequently used for repeat CS (29%), and it was the favoured technique (40%) when tubal ligation was performed at the time of CS (P
PubMed ID
23660040 View in PubMed
Less detail

[Vaginal birth after one previous cesarean section]

https://arctichealth.org/en/permalink/ahliterature92086
Source
Laeknabladid. 2008 Sep;94(9):591-7
Publication Type
Article
Date
Sep-2008
Author
Birgisdottir Brynhildur Tinna
Hardardottir Hildur
Bjarnadottir Ragnhildur I
Thorkelsson Thordur
Source
Laeknabladid. 2008 Sep;94(9):591-7
Date
Sep-2008
Language
Icelandic
Publication Type
Article
Keywords
Apgar score
Birth weight
Breech Presentation - surgery
Cesarean Section, Repeat
Emergency Treatment
Female
Fetal Death
Humans
Infant, Newborn
Live Birth
Perinatal mortality
Pregnancy
Retrospective Studies
Time Factors
Trial of Labor
Uterine Rupture - etiology - surgery
Vaginal Birth after Cesarean - adverse effects
Abstract
Objective: To evaluate the frequency of different modes of delivery after one previous cesarean section and those factors which may influence mode of delivery. Material and methods: During the study period (1.1.2001-31.12.2005) 925 women with a previous cesarean section and a following singleton pregnancy were identified and included. Information regarding mode of delivery, induction of labor, instrumental delivery, the urgency and indications for first and second cesarean section, birth weight and Apgar scores were collected retrospectively. Results: Trial of labor (TOL) was initiated for 564 women of which 61% were successful while 39% delivered by an emergent cesarean section. In total, 346 women delivered vaginally (37%), 341 women (37%) delivered with an elective cesarean section and 238 (26%) underwent an emergency cesarean section. The VBAC rate increased during the study period, from 35% to 46%. Women who underwent an elective cesarean section due to fetal malpresentation (most often breech) in their first pregnancy were significantly more likely to have a successful VBAC in their second pregnancy (53%) compared with women who had an elective cesarean section for any other indication (21%) (p4000 grams compared with
PubMed ID
18784385 View in PubMed
Less detail