Planned caesarean section or trial of vaginal delivery? A meta-analysis
- PMID: 25304604
- DOI: 10.1097/GCO.0000000000000114
Planned caesarean section or trial of vaginal delivery? A meta-analysis
Abstract
Purpose of review: This systematic review with meta-analysis aims to determine whether maternal outcomes are better with antenatal choice to give birth by caesarean section compared to vaginal birth, in singleton pregnancies in low-risk women without a subsequent pregnancy. The main outcome measures used were as follows: postpartum haemorrhage, postnatal depression, urinary incontinence and maternal mortality.
Recent findings: There were seven relevant studies (2 730 410 women) that were of high quality, identified for the purpose of this review. Randomized and observational evidence was synthesized, showing no real difference in maternal morbidity risk: maternal mortality (relative risk 0.19, 95% confidence interval 0.0013-27.27, P = 0.51); postpartum haemorrhage (relative risk 1.15, 95% confidence interval 0.40-3.31, P = 0.79) and blood transfusion (relative risk 0.91, 95% confidence interval 0.39-2.13, P = 0.84).
Summary: On the basis of the current research and the findings of this review, planned caesarean section is associated with a lower risk of developing urinary incontinence symptoms postpartum or having a blood transfusion yet conversely results showed an increased risk of postpartum haemorrhage. The synthesized data are not applicable to clinical practice; however, they prompt much further investigation into planned delivery and its associated morbidity risk.
Similar articles
-
Haemorrhage at caesarean section: a framework for prevention and research.Curr Opin Obstet Gynecol. 2016 Dec;28(6):492-498. doi: 10.1097/GCO.0000000000000328. Curr Opin Obstet Gynecol. 2016. PMID: 27787286 Review.
-
Trends and outcomes of postpartum haemorrhage, 2003-2011.BMC Pregnancy Childbirth. 2015 Dec 15;15:334. doi: 10.1186/s12884-015-0788-5. BMC Pregnancy Childbirth. 2015. PMID: 26670767 Free PMC article.
-
Does current evidence support the use of intraoperative cell salvage in reducing the need for blood transfusion in caesarean section?Curr Opin Obstet Gynecol. 2014 Dec;26(6):425-30. doi: 10.1097/GCO.0000000000000116. Curr Opin Obstet Gynecol. 2014. PMID: 25259949 Free PMC article. Review.
-
Risk of maternal and neonatal complications in subsequent pregnancy after planned caesarean section in a first birth, compared with emergency caesarean section: a nationwide comparative cohort study.BJOG. 2014 Jan;121(2):216-23. doi: 10.1111/1471-0528.12483. BJOG. 2014. PMID: 24373595
-
Effects of prolonged second stage, method of birth, timing of caesarean section and other obstetric risk factors on postnatal urinary incontinence: an Australian nulliparous cohort study.BJOG. 2011 Jul;118(8):991-1000. doi: 10.1111/j.1471-0528.2011.02928.x. Epub 2011 Apr 13. BJOG. 2011. PMID: 21489125
Cited by
-
Cost-effectiveness analysis of spontaneous vaginal delivery vs elective cesarean delivery for maternal outcomes in Colombia.AJOG Glob Rep. 2023 Mar 11;3(3):100196. doi: 10.1016/j.xagr.2023.100196. eCollection 2023 Aug. AJOG Glob Rep. 2023. PMID: 37415785 Free PMC article.
-
Pelvic floor: vaginal or caesarean delivery? A review of systematic reviews.Int Urogynecol J. 2021 Jul;32(7):1663-1673. doi: 10.1007/s00192-020-04550-8. Epub 2020 Oct 17. Int Urogynecol J. 2021. PMID: 33068134 Review.
-
Prenatal high-low impact exercise program supported by pelvic floor muscle education and training decreases the life impact of postnatal urinary incontinence: A quasiexperimental trial.Medicine (Baltimore). 2020 Feb;99(6):e18874. doi: 10.1097/MD.0000000000018874. Medicine (Baltimore). 2020. PMID: 32028397 Free PMC article. Clinical Trial.
-
Maternal complications and cesarean section without indication: systematic review and meta-analysis.Rev Saude Publica. 2017;51:105. doi: 10.11606/S1518-8787.2017051000389. Epub 2017 Nov 17. Rev Saude Publica. 2017. PMID: 29166440 Free PMC article. Review.
-
Perinatal consequences of a category 1 caesarean section at term.BMJ Open. 2015 Jul 29;5(7):e007248. doi: 10.1136/bmjopen-2014-007248. BMJ Open. 2015. PMID: 26224015 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials