Pregnancy

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Pregnancy

Birth-Labor

NEWS:

Caesareans 'may harm lung growth' "Researchers found they were up to four times more likely to have respiratory problems than those born naturally, or by emergency Caesarean section."

C-section raises risk to mother and infant "Compared with vaginal deliveries, cesarean deliveries have twice the risk of complications and deaths of both infants and mothers when the fetus is in the normal, head-down position, according to findings from a study conducted in Latin America. However, if the fetus is turned around - in the breech position - the benefits of cesarean delivery outweigh the risks, Dr. Jose Villar, at the University of Oxford in the UK, and associates report in BMJ Online First. "

C-Section Risk "The planned Caesarean birth mothers were more likely to have cardiac arrest, wound hematoma, hemorrhage requiring a hysterectomy, bacterial infection, anesthetic complications, and required longer hospital stays. … "

Infant outcome worse with planned c-section "Newborns who are delivered via planned cesarean section are more likely to be transferred to the neonatal intensive care unit and to experience lung disorders compared with those delivered via planned vaginal delivery, according to findings published in the American Journal of Obstetrics and Gynecology."

More U.S. women dying in childbirth "U.S. women are dying from childbirth at the highest rate in decades, new government figures show. Though the risk of death is very small, experts believe increasing maternal obesity and a jump in Caesarean sections are partly to blame. Some numbers crunchers note that a change in how such deaths are reported also may be a factor. "

Painful sex common after giving birth "A year after giving birth, many women are plagued by urinary incontinence, pain during sex and other problems, UK researchers report. Eighty-seven percent of mothers who responded to a survey complained of at least one health problem. Problems were particularly common among women who had delivered with the assistance of forceps. … Urinary incontinence was the most common problem reported, with roughly 54 percent reporting stress incontinence (the inability to hold urine when sneezing, lifting or experiencing some other type of stress); 37 percent having urge incontinence, meaning they had difficulty holding urine when experiencing the urge to urinate; and 33 percent reporting that they leaked urine on a continual basis. Sexual problems were also frequent, with about 54 percent of women reporting at least one issue, for example decreased libido or satisfaction with sex, and 30 percent reporting vaginal pain during sex."

Pros and Cons: Elective C-Section

Report: Planned Caesarean not risk-free " … the rate of severe complications, such as major bleeding, infection and blood clots, is three-fold higher overall in women having a planned Caesarean section compared with women who planned a natural birth."

Second-Born Twin Has Higher Post-Delivery Death Risk "Second-born twins are twice as likely as the firstborn to die at birth or shortly after due to complications during delivery, British researchers report. The risk -- which remains very small -- appears to be lessened when both twins are delivered by Caesarean section, the study found."

Women at long-term heart risk after preterm delivery " … women who had had a preterm infant were more than twice as likely to have cardiovascular disease as women who had not. Women who delivered infants that were both preterm and of low birth weight had a greater than threefold higher odds of having cardiovascular disease. "

ARTICLES:

JOURNAL ARTICLES:

Abdominal surgical incisions for caesarean section. (Cochrane Database Syst Rev. 2007) "AUTHORS' CONCLUSIONS: The Joel-Cohen incision has advantages compared to the Pfannenstiel incision. These are less fever, pain and analgesic requirements; less blood loss; shorter duration of surgery and hospital stay. These advantages for the mother could be extrapolated to savings for the health system. However, these trials do not provide information on severe or long-term morbidity and mortality."

Are there "unnecessary" cesarean sections? Perceptions of women and obstetricians about cesarean sections for nonclinical indications. (Birth. 2007) "Conclusions: Existing evidence for large numbers of women requesting cesarean sections in the absence of clinical indications is weak. This study supports the thesis that these women comprise a small minority. Psychological issues and maternal perceptions of risk appear to be significant factors in many maternal requests. Despite this finding, maternal request is perceived by obstetricians to be a major factor in driving the cesarean section rate upward."

Continuous versus interrupted sutures for repair of episiotomy or second degree tears. (Cochrane Database Syst Rev. 2007)

Decision making about mode of delivery among pregnant women who have previously had a caesarean section: A qualitative study. (BJOG. 2007)

Does cesarean section reduce postpartum urinary incontinence? A systematic review. (Birth. 2007)

Enemas during labour. (Cochrane Database Syst Rev. 2007)

First vaginal delivery at an older age: Does it carry an extra risk for the development of stress urinary incontinence? (Neurourol Urodyn. 2007) "CONCLUSIONS: First vaginal delivery at an older age carries an increased risk for postpartum SUI. Stress-incontinent women also had higher prevalence of SUI during pregnancy. This finding implies that the pathophysiologic process of SUI begins during pregnancy, prior to active labor and delivery. Nonetheless, elective cesarean section in these women has a protective effect and lowers the risk of developing postpartum SUI."

Induction of labor with prostaglandins for medical reasons: Determining explanatory variables of the induction to delivery time interval for vaginal deliveries and caesarean section. (Eur J Obstet Gynecol Reprod Biol. 2007) "CONCLUSION: PROM was the only medical reason to influence the outcome of an induction with prostaglandins locally, other significant explanatory variables were the cervix score, parity, the number of applied prostaglandin tablets and the gestational age, whereas other factors, such as diabetes, body mass index and body weight had no significant influence."

Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term (CMAJ 2007) "Interpretation: Although the absolute difference is small, the risks of severe maternal morbidity associated with planned cesarean delivery are higher than those associated with planned vaginal delivery. These risks should be considered by women contemplating an elective cesarean delivery and by their physicians."

Overview. Preterm labour: mechanisms and management. (BMC Pregnancy Childbirth. 2007)

Postpartum urinary retention after cesarean delivery. (Int J Gynaecol Obstet. 2007) "CONCLUSION:: Our results revealed PUR was a common phenomenon in patients who had a cesarean delivery, and morphine-related postoperative analgesia was the main contributing factor."

Probiotics for preventing preterm labour. (Cochrane Database Syst Rev. 2007) " AUTHORS' CONCLUSIONS: Although the use of probiotics appears to treat vaginal infections in pregnancy, there are currently insufficient data from trials to assess impact on preterm birth and its complications."

Risk Factors for Fecal and Urinary Incontinence After Childbirth: The Childbirth and Pelvic Symptoms Study. (Am J Gastroenterol. 2007)

Risks of adverse outcomes in the next birth after a first cesarean delivery. (Obstet Gynecol. 2007)

Treatment for primary postpartum haemorrhage. (Cochrane Database Syst Rev. 2007)

[What are the risk factors of anal incontinence after vaginal delivery?] (J Chir (Paris). 2007)

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