Thursday, November 13, 2008

When doing nothing is the best course of action

Many C-Sections Can Be Avoided By Waiting Out Stalled Labor for an extra two hours, according to a new study:
"One third of all first-time cesareans are performed due to active-phase arrest during labor, which contributes to approximately 400,000 surgical births per year," said [study author Dr. Aaron] Caughey, who is affiliated with the UCSF National Center of Excellence in Women's Health. "In our study, we found that just by being patient, one third of those women could have avoided the more dangerous and costly surgical approach."

The cesarean delivery rate reached an all-time high in 2006 of 31.1 percent of all deliveries, according to the UCSF study. Arrest in the active phase of labor has been previously shown to raise the risk of cesarean delivery between four- and six-fold.

"Cesarean delivery is associated with significantly increased risk of maternal hemorrhage, requiring a blood transfusion, and postpartum infection," Caughey said. "After a cesarean, women also have a higher risk in future pregnancies of experiencing abnormal placental location, surgical complications, and uterine rupture."
The study also notes that ACOG already recommends waiting at least two hours before proceeding with a cesarean when adequate contractions in active labor produce no progress , but "it is routine practice in many clinical settings to proceed with a cesarean for 'lack of progress' before those ACOG criteria have been met", according to Caughey.

HT: Unnecessarian

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