Factors Associated with the Recent Increasing Cesarean Delivery Rate at a Japanese Perinatal Center

Objective. We examined which specific factors contributed to the increase in Cesarean delivery rate at our hospital over a 10-year period. Methods. From January 2002 to December 2012, data on the Japanese singleton deliveries at ≥22-week gestation managed at Japanese Red Cross Katsushika Maternity Hospital were collected. Potential factors associated with the increasing Cesarean delivery rate were selected according to previous studies. In this study, the incidences of intrauterine fetal demise, umbilical artery pH <7.1, and severe perineal laceration were calculated for each year. Results. The Cesarean delivery rate at our institution increased significantly during the study period (17.3% in 2002 versus 23.4% in 2012, P<0.01). During the study period, the Cesarean delivery rates in the cases of nulliparity, preterm delivery, low birth weight (<2,500 g), previous Cesarean deliveries and breech presentation were increased significantly. The incidence of intrauterine fetal demise and low umbilical artery pH was significantly decreased, and a negative correlation was found between the Cesarean delivery rate and the incidence of low umbilical artery pH for each year (r=−0.92, P<0.01). Conclusion. At our institute, the neonatal outcomes seemed to be improved associated with the increased Cesarean delivery rate between 2002 and 2012.

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The Relevance of the Second Cesarean Delivery in the Reduction of Institutional Cesarean Delivery Rates

Medical Principles and Practice ◽

10.1159/000493362 ◽

2018 ◽

Vol 27 (6) ◽

pp. 555-561 ◽

Cited By ~ 1

Author(s):

Michael F.E. Diejomaoh ◽

Waleed Al-Jassar ◽

Zainab Bello ◽

Kavitha Karunakaran ◽

Asiya Mohammed

Keyword(s):

Cesarean Delivery ◽

Maternity Hospital ◽

Delivery Rate ◽

Cesarean Deliveries ◽

Fetal Birth Weight ◽

Gestational Age At Delivery ◽

Group A ◽

Cesarean Delivery Rate ◽

Group B ◽

Repeat Cesarean Delivery

Objective: The cesarean delivery rate has increased worldwide. The aim of our study was to assess the events associated with the second cesarean deliveries in our institution. Subjects and Methods: All cesarean deliveries at the Maternity Hospital, Kuwait, from January 1 to December 31, 2013, were identified. A comparative study was undertaken on patients having their first and second cesarean deliveries. The social and clinical characteristics of these patients were extracted from our records and the antenatal, intrapartum, and postpartum course of the pregnancies and their outcomes documented. Results: During the study period, 10,586 deliveries were recorded, including 3,676 cesarean deliveries, i.e., a cesarean delivery rate of 34.7%. 840 of these patients were undergoing their first cesarean delivery (group A) and 607 patients were undergoing their second (group B); 484 patients from group A and 341 patients from group B with complete records were analyzed. Mean age (30.89 ± 4.93 vs. 29.94 ± 5.56 years, p = 0.008), parity (1.49 ± 1.22 vs. 0.98 ± 1.60, p < 0.0001), gestational age at delivery (38.12 ± 2.61 vs. 37.66 ± 3.11 weeks, p = 0.02), and fetal birth weight (3,211.60 ± 691.51 vs. 2,829.73 ± 863.26 g, p < 0.001) were significantly higher in group B than in group A. 53.2% of the patients in group B requested repeat cesarean delivery, their second cesarean. The rate of maternal morbidity was low. Conclusions: The incidence of repeat cesarean delivery in group B is high, and its reduction should contribute to a lowering of the overall cesarean delivery rate.

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Reasons for the High Cesarean Delivery Rate among Women with Ankylosing Spondylitis: Using the Korean National Health Insurance Database

The Journal of Rheumatology ◽

10.3899/jrheum.190754 ◽

2019 ◽

Vol 47 (5) ◽

pp. 668-673

Author(s):

Jung Sun Lee ◽

Ji Seon Oh ◽

Ye-Jee Kim ◽

Seokchan Hong ◽

Chang-Keun Lee ◽

...

Keyword(s):

Health Insurance ◽

Ankylosing Spondylitis ◽

Cesarean Delivery ◽

Maternal Age ◽

Disease Duration ◽

Delivery Rate ◽

Factors Associated ◽

Vaginal Deliveries ◽

Cesarean Births ◽

Cesarean Delivery Rate

Objective.Women with ankylosing spondylitis (AS) have reported a higher rate of cesarean births than healthy controls. This study aimed to identify factors associated with cesarean births in women with AS.Methods.Based on the Korean Health Insurance Review and Assessment Service claims database, the subjects comprised female patients aged 20–49 years old with AS. In total, 1293 deliveries after AS diagnosis were included. A logistic regression analysis was performed to identify factors associated with cesarean births.Results.Among the 1293 deliveries in women with AS, 657 were cesarean and 636 were vaginal deliveries. Compared to vaginal delivery, the women who had cesarean deliveries were older, had a longer disease duration, and had a higher portion of primipara and dispensation of drugs. These factors were associated with a higher risk of cesarean delivery: maternal age (OR 1.08, 95% CI 1.04–1.12), disease duration (OR 1.09, 95% CI 1.03–1.14), and preeclampsia (OR 3.94, 95% CI 1.17–13.32). Further, compared to no drug dispensation, these drugs showed higher risks of cesarean delivery: nonsteroidal antiinflammatory drugs (NSAID; OR 1.64, 95% CI 1.31–2.37), tumor necrosis factor inhibitor (TNFi), disease-modifying antirheumatic drugs (DMARD), or corticosteroids (OR 2.01, 95% CI 1.57–2.58). In the subgroup analysis in primiparas, maternal age, or dispensation of NSAID alone, or TNFi, DMARD, or corticosteroids was associated with a higher risk of cesarean delivery.Conclusion.Women with AS showed a higher cesarean delivery rate, influenced by both maternal age and disease-related factors.

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High dose vs. low dose oxytocin for labor augmentation: a systematic review and meta-analysis of randomized controlled trials

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0042 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Rehab Abdelhamid Aboshama ◽

Ahmed Mohamed Abdelhakim ◽

Mohammad Abrar Shareef ◽

Abdulhadi A. AlAmodi ◽

Mohammad Sunoqrot ◽

...

Keyword(s):

Cesarean Delivery ◽

Low Dose ◽

Delivery Rate ◽

Cochrane Library ◽

High Dose ◽

Safety And Efficacy ◽

Labor Duration ◽

Uterine Hyperstimulation ◽

Cesarean Delivery Rate ◽

Labor Augmentation

AbstractObjectivesTo compare the safety and efficacy between high dose and low dose oxytocin administration for labor augmentation.MethodsWe searched for the available studies during March 2020 in PubMed, Cochrane Library, Scopus, and ISI Web of science. All randomized clinical trials (RCTs) that assessed safety and efficacy of high dose vs. low dose oxytocin for labor augmentation were considered. The extracted data were entered into RevMan software. Dichotomous and continuous data were pooled as odds ratio (OR) and mean difference (MD) respectively, with the corresponding 95% confidence intervals (CI). Our main outcomes were cesarean delivery rate, spontaneous vaginal delivery rate, uterine hyperstimulation and tachysystole, and labor duration from oxytocin infusion.ResultsEight RCTs with 3,154 patients were included. High dose oxytocin did not reduce cesarean delivery rate compared to low dose oxytocin (OR=0.76, 95% CI [0.52, 1.10], p=0.15). After solving the reported heterogeneity, high dose oxytocin did not increase the rate of spontaneous vaginal deliveries vs. low dose oxytocin (OR=1.06, 95% CI [0.84, 1.32], p=0.64). Low dose oxytocin was linked to a significant decline in uterine hyperstimulation and tachysystole (p>0.001). A reduction in labor duration was found in high dose oxytocin group over low oxytocin regimen (MD=−1.02 h, 95% CI [−1.77, −0.27], p=0.008).ConclusionsWe found no advantages for high dose oxytocin over low dose oxytocin in labor augmentation except in reducing labor duration. Low dose oxytocin is safer as it decreases the incidence of uterine hyperstimulation and tachysystole. More trials are needed to confirm our findings.

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