Predictive models of individual risk of elective caesarean section complications: a systematic review

There is a lack of evidence on the effects of perioperative warming on maternal and neonatal outcomes in women undergoing elective caesarean section who are performing at-birth skin-to-skin contact. This study aimed to provide a systematic review of the current evidence base on the effects of perioperative warming versus no warming. Inclusion criteria included randomised controlled trials involving pregnant women ≥18 years old undergoing an elective caesarean section at term under regional anaesthesia and who initiated at-birth neonatal skin-to-skin contact. Studies investigated active warming versus no active warming interventions. Three studies were included, with a total of 286 participants. Active warming of women resulted in significantly less occurrence of neonatal hypothermia, with no difference in maternal hypothermia. Perioperative active warming of mothers and newborns who had skin-to-skin contact may be beneficial. The quality of the included studies was low, so the review findings should be interpreted with caution. High quality studies with larger sample sizes need to be undertaken.

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Antenatal steroid administration in medically uncomplicated pregnancy beyond 37 weeks of gestation for the prevention of neonatal morbidities prior to elective caesarean section: a systematic review and meta-analysis of randomised controlled trials

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.1080/14767058.2016.1205031 ◽

2016 ◽

Vol 30 (10) ◽

pp. 1151-1157 ◽

Cited By ~ 4

Author(s):

Ravisha Srinivasjois ◽

Desiree Silva

Keyword(s):

Systematic Review ◽

Caesarean Section ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Elective Caesarean Section ◽

Controlled Trials ◽

Steroid Administration ◽

Uncomplicated Pregnancy ◽

Antenatal Steroid ◽

Randomised Controlled

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Hyperbaric vs. isobaric bupivacaine for spinal anaesthesia for elective caesarean section: a Cochrane systematic review

Anaesthesia ◽

10.1111/anae.14084 ◽

2017 ◽

Vol 73 (4) ◽

pp. 499-511 ◽

Cited By ~ 11

Author(s):

B. L. Sng ◽

N. L. R. Han ◽

W. L. Leong ◽

R. Sultana ◽

F. J. Siddiqui ◽

...

Keyword(s):

Systematic Review ◽

Caesarean Section ◽

Spinal Anaesthesia ◽

Elective Caesarean Section ◽

Cochrane Systematic Review

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2 Prospect guideline for elective caesarean section: updated systematic review and procedure-specific postoperative pain management recommendations

10.1136/rapm-2021-esra.2 ◽

2021 ◽

Author(s):

E Veef ◽

E Roofthooft ◽

M Van de Velde ◽

PROSPECTWorking Group

Keyword(s):

Systematic Review ◽

Pain Management ◽

Postoperative Pain ◽

Caesarean Section ◽

Elective Caesarean Section ◽

Postoperative Pain Management ◽

Management Recommendations

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A Systematic Review on the Effectiveness of Implementation Strategies to Postpone Elective Caesarean Sections to ≥39+(0-6) Week of Gestation.

10.21203/rs.3.rs-87218/v1 ◽

2020 ◽

Author(s):

Barbara Prediger ◽

Anahieta Heu-Parvaresch ◽

Stephanie Polus ◽

Stefanie Bühn ◽

Edmund A.M. Neugebauer ◽

...

Keyword(s):

Systematic Review ◽

Caesarean Section ◽

Narrative Analysis ◽

Implementation Strategy ◽

Neonatal Intensive Care ◽

Elective Caesarean Section ◽

Implementation Strategies ◽

Interrupted Time Series ◽

Risk Difference ◽

Specific Barriers

Abstract Background: Caesarean sections often have no urgent indication and are electively planned. Research showed that elective caesarean section should not be performed until 39+(0-6) week of gestation to ensure best neonatal and maternal health if there are no contraindications. This was recommended by various guidelines published in the last two decades. With this systematic review we are looking for implementation strategies trying to implement these recommendations into clinical practice. Methods: We performed a systematic literature search in MEDLINE, EMBASE, CENTRAL and CINAHL in November 2019. We included studies that assessed implementation strategies aiming to postpone elective caesarean section to ≥39+(0-6) week of gestation. There were no restrictions regarding the type of implementation strategy or reasons for elective caesarean section. Our primary outcome was the rate of elective caesarean sections before 39+(0-6) week of gestation. We did a narrative analysis of the results.Results: We included 9 studies, of which were 2 interrupted time series and 7 before-after studies, covering 205.954 elective caesarean births. All studies included various types of implementation strategies. All implementation strategies showed success in decreasing the rate of elective caesarean sections performed <39+(0-6) week of gestation. Risk difference differed from -7 (95% CI -8; -7) to -45 (95% CI -51; -31). 3 studies reported rate of neonatal intensive care unit admission and showed little reduction.Conclusion: This systematic review shows that all presented implementation strategies to reduce elective caesarean section before 39+(0-6) weeks of gestation are effective. Reduction rates differ widely and it remains unclear which strategy is most successful. Strategies used locally in one hospital seem a little more effective. For planning an implementation strategy to reduce elective caesarean section before 39+(0-6) weeks of gestation it is necessary to consider specific barriers and facilitators and take all obstetric personal into account.Systematic review registration: Registered in PROSPERO (CRD42017078231)

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