This article describes a quality improvement project in which early skin-to-skin (STS) contact, in the operating room (OR) and during recovery, was used as an intervention to increase the success of breastfeeding initiation among healthy infants after cesarean, at a large, urban, acute care teaching hospital. The nursing role is key for the intervention, but the program involves the entire peri...

BACKGROUND The aim of this study was to identify the appropriateness of cesarean sections, performed in Tehran hospitals using standardized Rand Appropriateness Method (RAM) criteria. METHODS In this study we used the RAM criteria. In order to prepare the list of cesarean scenarios, clinical guidelines were selected, and the Appraisal of Guidelines for Research and Evaluation was used to choo...

The objective of the present study was to investigate factors associated with cesarean sections in two cities located in different regions of Brazil and to determine factors that explain the higher cesarean section rate in the more developed city, Ribeirão Preto, compared to the less developed one, São Luís. Data from two cohort studies comprising 2846 women in Ribeirão Preto in 1994, and 2443 ...

BACKGROUND The relationship between perinatal outcome and anesthetic technique for preterm cesarean sections has not been explored in South Eastern, Nigeria. OBJECTIVE The objective of the following study is to evaluate perinatal outcome in preterm cesarean sections conducted under general anesthesia (GA) and subarachnoid block (SAB) with the aim to ascertain any difference in outcome between...

OBJECTIVE This study was undertaken to assess the safety of trial of labor after previous cesarean delivery. STUDY DESIGN Retrospective cohort study of 308,755 Canadian women with previous cesarean delivery between 1988 and 2000. Occurrences of in-hospital maternal death, uterine rupture, and other severe maternal morbidity were compared between women with a trial of labor and those with an e...

To describe appropriate maternal and obstetrical indications for primary cesarean delivery. The list of potential indications is long. Among all maternal and obstetrical indications, labor dystocia is the most common; multifetal pregnancy and malpresentation are not infrequent. Maternal indications, including human immunodeficiency virus (with high viral load) and herpes simplex virus (with act...

Cesarean deliveries on maternal request (CDMR) have become increasingly common in China within the past 20 years, coinciding with the dramatic rise in cesarean section rates. In recent years, the state has tried to control the escalation of cesarean section rates by restricting those that are considered medically “unnecessary” and particularly those requested by mothers. Drawing upon eight week...

OBJECTIVE To describe the factors associated with unjustified Cesarean section. DESIGN Cross-sectional study. SETTING Four hospitals providing obstetric services, two that serve patients insured through their employer (contributive regimen) and two that serve privately insured patients, in Cali, Colombia. STUDY PARTICIPANTS Four hundred and sixteen patients with Cesarean section performed...

BACKGROUND AND OBJECTIVES During the past few decades, there has been a significant increase in the number of cesarean deliveries, and thus an increase in the number of complications. A common complication of multiple cesarean deliveries is symptomatic uterine scar dehiscence, for which there are no treatment guidelines available. We report a case of uterine scar dehiscence-the repair of it by ...

Attempts to define, or enforce, an "ideal" cesarean section rate are futile, and should be abandoned. The cesarean rate is a consequence of individual value-laden clinical decisions, and is not amenable to the methods of evidence-based medicine. The influence of academic authority figures on the cesarean rate in the US is placed in historic context. Like other population health indices, the ces...