Rising Cesarean Delivery Rate in America: What Are the Consequences?

Obstetric Anesthesia


Anesthesia for Cesarean Delivery


The Rising Cesarean Delivery Rate in America: What Are the Consequences?


Blanchette H (New York Med College, Valhalla) Obstet Gynecol 118:687-690, 2011§



D.H. Chestnut, MD



Evidence Ranking


• D



Expert Rating


• 1



Abstract


Cesarean delivery is now the most common operation in the United States, and it has increased dramatically from 5.8% in 1970 to 32.3% in 2008. This rise has not resulted in significant improvement in neonatal morbidity or maternal health. Three recent studies of elective repeat cesarean deliveries performed before 39 completed weeks of gestation have demonstrated increased respiratory and other adverse neonatal outcomes. Maternal mortality in the United States has increased from 10 per 100,000 to 14 per 100,000 from 1998 to 2004. Contributing to this is an increasing incidence of placenta accreta associated with multiple uterine scars requiring the need for emergency cesarean hysterectomy, blood transfusion, and maternal mortality due to obstetric hemorrhage. To reverse the trend of the rising cesarean delivery rate, obstetricians must reduce the primary rate and avoid the performance of a uterine incision unless absolutely necessary for fetal or maternal indications. For women with one previous low transverse cesarean delivery, obstetricians should promote a trial of labor after previous cesarean delivery in those women who desire three or more children.

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Jan 28, 2017 | Posted by in ANESTHESIA | Comments Off on Rising Cesarean Delivery Rate in America: What Are the Consequences?

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