OBJECTIVES The World Health Organization considers Cesarean section rates of 5-15% to be the optimal range for targeted provision of this life saving intervention. However, access to safe Cesarean section in resource-limited settings is much lower, estimated at 1-2% reported in sub-Saharan Africa. This study reports Cesarean sections rates and indications in Democratic Republic of Congo, Burund...

BACKGROUND Twin birth is associated with a higher risk of adverse perinatal outcomes than singleton birth. It is unclear whether planned cesarean section results in a lower risk of adverse outcomes than planned vaginal delivery in twin pregnancy. METHODS We randomly assigned women between 32 weeks 0 days and 38 weeks 6 days of gestation with twin pregnancy and with the first twin in the cepha...

MANAGEMENT of labor after previous cesarean delivery continues to be a controversial area of obstetric practice. Neither repeat cesarean delivery nor a trial of labor are without risk. Currently, cesarean delivery is the most commonly performed operation, and repeat cesarean delivery is the most common indication. Although the prevalence of vaginal birth after cesarean delivery (VBAC) increased...

OBJECTIVES To characterize the indications for primary cesarean delivery in a large national cohort and to identify opportunities to lower the U.S. primary cesarean delivery rate. METHODS A retrospective cohort study of the 38,484 primary cesarean deliveries among the 228,562 deliveries at sites participating in the Consortium on Safe Labor from 2002 to 2008. RESULTS The primary cesarean de...

AIMS The objective of this paper was to review our institution's cesarean delivery rates starting in 2004 prior to the full implementation of a patient safety program including a uniform oxytocin policy until 2012 when the oxytocin policy and the safety program had been fully implemented. RESULTS Cesarean delivery rates at our institution decreased incrementally from 41.6 % in 2004 to 32.7 % ...

OBJECTIVE The purpose of this study was to determine whether the proportion of cesarean deliveries in pregnant women with a history of genital herpes and no active lesions at birth is higher than that in women with no history of genital herpes, and to determine whether this risk was modified by birth facilities' underlying prevalence of cesarean delivery. METHODS This was a retrospective surv...

BACKGROUND The literature is nearly unanimous in recommending elective cesarean delivery at 39 weeks of gestation because of the lower rates of neonatal respiratory complications compared to 38 weeks. However, elective cesarean delivery at 39 weeks or more may have maternal and other fetal consequences compared to delivery at 38 weeks, which are not always addressed in these studies. DISCUSSI...

Introduction: The purpose of this study was to examine the clinical usefulness of postoperative epidural analgesia in patients possessing severe gestational hypertension after Cesarean delivery. Methods: We reviewed the obstetric records of 99 patients possessing severe gestational hypertension undergoing singleton Cesarean delivery at ≥22 weeks’ gestation. Thirty patients were received continu...

BACKGROUND High cesarean section rates in Brazilian public hospitals and higher rates in private hospitals are well established. Less is known about the relationship between payment source and cesarean section rates within public and private hospitals. METHODS We analyzed the 1998, 2003, and 2008 rounds of a nationally representative household survey (PNAD), which includes type of delivery, w...

OBJECTIVE To describe currently accepted methods for managing the term breech pregnancy, and to predict the delivery outcomes and costs of each method. METHODS Literature review was used to derive four options for the peripartum management of the term breech pregnancy. Using decision-analysis techniques, we calculated the predicted delivery outcomes and costs associated with each option. RE...