Obstetrics & Gynecology Email Alerts
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Obstetrics & Gynecology 2004;103:907-912
© 2004 by The American College of Obstetricians and Gynecologists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Burrows, L. J.
Right arrow Articles by Weber, A. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Burrows, L. J.
Right arrow Articles by Weber, A. M.
Related Collections
Right arrow Obstetric complications of pregnancy
Right arrow Urogynecology
Right arrow Epidemiology/public health

ORIGINAL RESEARCH

Maternal Morbidity Associated With Vaginal Versus Cesarean Delivery

Lara J. Burrows, MD, Leslie A. Meyn, MS and Anne M. Weber, MD, MS

From the Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, Pittsburgh, Pennsylvania.

Address reprint requests to: Dr. Lara J. Burrows, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213; e-mail: lburrows{at}mail.magee.edu.

OBJECTIVE: To describe postpartum maternal morbidity associated with mode of delivery in term, singleton pregnancies.

METHODS: The Magee Obstetric Medical and Infant database was examined for the years 1995 to 2000. Patients were grouped into 6 types of delivery mode: spontaneous vaginal delivery, operative vaginal delivery, primary cesarean delivery without trial of labor, primary cesarean delivery with trial of labor, repeat cesarean delivery without trial of labor, and repeat cesarean delivery with trial of labor. Multivariable logistic regression provided odds ratios and 95% confidence intervals (CI) for morbidity by delivery mode adjusted for demographic characteristics and comorbidities. Spontaneous vaginal delivery was used as the referent group (odds ratio = 1).

RESULTS: Of 32,834 subjects, 27,178 had vaginal delivery (operative = 4,908; spontaneous = 22,270) and 5,656 had cesarean delivery. Third- or fourth-degree lacerations occurred in 1,733 (7.8%) women who had spontaneous vaginal delivery compared with 1,098 (22.3%) who had operative vaginal delivery. Overall, 523 women (1.6%) had endometritis. Compared with spontaneous vaginal delivery, primary cesarean delivery with trial of labor conferred a 21.2-fold increased risk of endometritis (95% CI 15.4, 29.1). Even without trial of labor, women after primary cesarean delivery were 10.3 times more likely to develop endometritis (95% CI 5.9, 17.9) than after spontaneous vaginal delivery. The risk of transfusion was highest in women delivered by primary cesarean after labor, 4.2 times higher (95% CI 1.8, 10.1) than spontaneous vaginal delivery. The risk of pneumonia was 9.3 times higher (95% CI 3.4, 25.6) after repeat cesarean delivery with labor. Deep venous thromboses occurred in 15 (0.1%) after spontaneous vaginal delivery, 2 (0.04%) after operative vaginal delivery, and 12 (0.2%) after cesarean delivery.

CONCLUSION: Compared with spontaneous vaginal delivery, cesarean delivery is associated with increased risks of endometritis, the need for transfusion, and pneumonia; however, these rates are lower than reported previously.

LEVEL OF EVIDENCE: II-2




This article has been cited by other articles:


Home page
 Obstet GynecolHome page
B. M. Mercer, S. Gilbert, M. B. Landon, C. Y. Spong, K. J. Leveno, D. J. Rouse, M. W. Varner, A. H. Moawad, H. N. Simhan, M. Harper, et al.
Labor Outcomes With Increasing Number of Prior Vaginal Births After Cesarean Delivery
Obstet. Gynecol., February 1, 2008; 111(2): 285 - 291.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
A. T. N. Tita, J. C. Hauth, A. Grimes, J. Owen, A. M. Stamm, and W. W. Andrews
Decreasing Incidence of Postcesarean Endometritis With Extended-Spectrum Antibiotic Prophylaxis
Obstet. Gynecol., January 1, 2008; 111(1): 51 - 56.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
J. Kjeldsen-Kragh, M. K. Killie, G. Tomter, E. Golebiowska, I. Randen, R. Hauge, B. Aune, P. Oian, L. B. Dahl, J. Pirhonen, et al.
A screening and intervention program aimed to reduce mortality and serious morbidity associated with severe neonatal alloimmune thrombocytopenia
Blood, August 1, 2007; 110(3): 833 - 839.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
A. G. Visco, M. Viswanathan, K. N. Lohr, M. E. Wechter, G. Gartlehner, J. M. Wu, R. Palmieri, M. J. Funk, L. Lux, T. Swinson, et al.
Cesarean Delivery on Maternal Request: Maternal and Neonatal Outcomes
Obstet. Gynecol., December 1, 2006; 108(6): 1517 - 1529.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
C. Deneux-Tharaux, E. Carmona, M.-H. Bouvier-Colle, and G. Breart
Postpartum Maternal Mortality and Cesarean Delivery.
Obstet. Gynecol., September 1, 2006; 108(3): 541 - 548.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
Rates of Cesarean Delivery Among Puerto Rican Women--Puerto Rico and the U.S. Mainland, 1992-2002
JAMA, March 22, 2006; 295(12): 1369 - 1371.
[Full Text] [PDF]

Home page
 Obstet GynecolHome page
S. Riskin-Mashiah
Maternal Morbidity Associated With Vaginal Versus Cesarean Delivery
Obstet. Gynecol., September 1, 2004; 104(3): 633 - 633.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2004 by the American College of Obstetricians and Gynecologists.