A Comparative Study of the Spontaneous Labor Rate in Scheduled Elective Cesarean Section at 38 Weeks versus 39 Weeks of Gestation in Parturient with Previous Cesarean Section
Todumrong, N.; Somprasit, C.; Tanprasertkul, C.; Bhamarapravatana, K.; Suwannarurk, K.
Journal of the Medical Association of Thailand 99 Suppl. 4: S37-S41
2016
ISSN/ISBN: 0125-2208 PMID: 29916674 Document Number: 5664
To assess the effect of the different scheduled gestational age for a repeat elective cesarean section (CS) on emergency cesarean section rate and adverse pregnancy outcomes in pregnant women with history of previous CS. A prospective cohort study of singleton pregnant women who had a history of CS and were scheduled for a repeat elective CS to be performed. The cases were divided into two groups of which the elective CS was appointed at 38 or 39 weeks of gestation as study and control groups, respectively. Emergency cesarean section rate, maternal and neonatal complications were defined as main outcomes. Of 415 scheduled elective repeat cesarean deliveries performed at 38 weeks of gestation or later, 209 were scheduled between 38 0/7 and 38 6/7 weeks (study group), and 206 were scheduled between 39 0/7 and 39 6/7 weeks (control group). Most of the cases had one previous cesarean delivery. The emergency CS rate before schedule in the study group was significantly less than in the control group (15.3% vs. 51%, p<0.001). Spontaneous labor pain was a major factor to have unplanned delivery. The maternal intra-operative complications were significantly increased in women who had emergency cesarean before schedule compared to elective CS on scheduled in 38 weeks group (25% vs. 12.9%, p<0.001) and 39 weeks group (31.4% vs. 14%, p<0.001). The major intra-operative complication was uterine atony. There were no statistically The emergency CS rate in 39 weeks gestation group was significantly higher than 38 weeks group. The