AIM: To compare the mortality, morbidity of emergency and elective cesarean section with vaginal delivery among Asian teaching hospitals. METHODS: Hospital based prospective study at 12 centers of 9 countries. RESULTS: 12 591 vaginal deliveries, 3062 elective and 4328 emergency cesarean section were followed up to 5 days postpartum. Maternal deaths (95% CI) per 1000 births among vaginal deliveries being 0.47 (0.17, 1.03) was not significantly different from 0.31 (0.01, 1.73) of elective cesarean section and both rates were significantly lower than 2.87 (1.53, 4.91) per 1000 births of emergency section. The vaginal delivery group had significantly lower incidences of all major complication except significantly higher chance of secondary operations and non-significantly different risk for endometritis. Corresponding neonatal mortality per 1000 deliveries among the three groups were 7 (5.6, 8.6), 2.2 (0.9, 4.6) and 12.4 (9.3, 16.2) (P < 0.001). Vaginal delivery also had higher rates of severe asphyxia and palsy than elective cesarean section. CONCLUSION: Maternal complications were increased by cesarean delivery but elective section may reduce neonatal complication.
AIM: To compare the mortality, morbidity of emergency and elective cesarean section with vaginal delivery among Asian teaching hospitals. METHODS: Hospital based prospective study at 12 centers of 9 countries. RESULTS: 12 591 vaginal deliveries, 3062 elective and 4328 emergency cesarean section were followed up to 5 days postpartum. Maternal deaths (95% CI) per 1000 births among vaginal deliveries being 0.47 (0.17, 1.03) was not significantly different from 0.31 (0.01, 1.73) of elective cesarean section and both rates were significantly lower than 2.87 (1.53, 4.91) per 1000 births of emergency section. The vaginal delivery group had significantly lower incidences of all major complication except significantly higher chance of secondary operations and non-significantly different risk for endometritis. Corresponding neonatal mortality per 1000 deliveries among the three groups were 7 (5.6, 8.6), 2.2 (0.9, 4.6) and 12.4 (9.3, 16.2) (P < 0.001). Vaginal delivery also had higher rates of severe asphyxia and palsy than elective cesarean section. CONCLUSION: Maternal complications were increased by cesarean delivery but elective section may reduce neonatal complication.
Authors: Gordon Cs Smith; Alexandros A Moraitis; David Wastlund; Jim G Thornton; Aris Papageorghiou; Julia Sanders; Alexander Ep Heazell; Stephen C Robson; Ulla Sovio; Peter Brocklehurst; Edward Cf Wilson Journal: Health Technol Assess Date: 2021-02 Impact factor: 4.014
Authors: Ana Paula Esteves-Pereira; Catherine Deneux-Tharaux; Marcos Nakamura-Pereira; Monica Saucedo; Marie-Hélène Bouvier-Colle; Maria do Carmo Leal Journal: PLoS One Date: 2016-04-13 Impact factor: 3.240