China
Africa
Explore chapters and articles related to this topic
Cesarean Delivery
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
A. Dhanya Mackeen, Meike Schuster
Cesarean delivery by maternal request (CDMR) indicates that the sole reason for CD is the woman’s preference for CD and her refusal to labor in the case of a cephalic, singleton gestation. Although the true rates are unknown, it is estimated that the incidence of CDMR is approximately 2% in the United States and less in low-income countries [3, 4]. CDMR has increased as cesarean complications diminish, women have fewer children, and fear or concerns about vaginal delivery persist. This practice is supported by the American Congress of Obstetricians and Gynecologists (ACOG), the Society of Obstetrics and Gynecology of Canada, the Brazilian Medical Association, and the National Institutes of Health State-of-the-Science Conference on Cesarean Delivery on Maternal Request [4–7]. Uniformly, these medical authorities recommend shared decision-making between patient and provider and that the provider explore the patient’s motivation for CDMR to help determine the most appropriate mode of delivery. Two meta-analyses found increased risks of bleeding, infections, and respiratory complications associated with unindicated CD [6, 8], while two other meta-analyses found increased urinary incontinence and pelvic organ prolapse, but not anal incontinence [9, 10], associated with vaginal delivery.
Management of pregnancy with a history of late neonatal/infant death
Published in Minakshi Rohilla, Recurrent Pregnancy Loss and Adverse Natal Outcomes, 2020
Darshan Hosapatna Basavarajappa
Elective cesarean delivery on maternal request should not be encouraged pertaining to the apprehension of the mother undergoing the psychological trauma of previous neonatal death. Appropriate counseling and assurance of well-being is of utmost importance.
Analysing the likelihood of caesarean birth after implementation of the two-childbirth policy in China, using the Ten Group Classification System
Published in Journal of Obstetrics and Gynaecology, 2020
Jie Wen, QinQing Chen, Qiong Luo
In China, the one-child policy was firmly enforced for over 30 years. Due to the one-child policy, a large number of women preferred having a Caesarean delivery on maternal request without medical indication to assure foetal safety in the belief that they would have no further pregnancies, which became a substantial driver of the high Caesarean delivery rate. This accounted for an estimated 40% of Caesarean deliveries in China in 2010 (Zhu et al. 2012). With the emergence of population ageing problems, the one-child policy in China came to an end in 2014. The selective, two-child policy was announced and specified that a couple could have two children if one spouse was only one child (Zeng and Hesketh 2016). In October 2015, the universal two-children policy replaced the one-child policy across China. The new policy encourages fertility intention and allows all couples to have two children. Such a change may change women’s decision-making with regard to their birth mode and make women consider the harms associated with a Caesarean birth more carefully, especially the potential risks for their further pregnancies (Gu et al. 2018).
An unusual case of peritonitis following a caesarean delivery
Published in Alexandria Journal of Medicine, 2018
Ahmed Gado, Hesham Badawi, Ahmed Karim
This case report describes an unusual case of peritonitis of unknown origin following an elective caesarean delivery with serious post exploratory laparotomy complications. Complete recovery occurred in spite of these serious complications. Authors could not determine the etiology of the serous fluid in this patient suggestive of idiopathic allergic or inflammatory reaction of the peritoneum. This is the second reported case of postoperative fluid accumulation of unknown origin after caesarean delivery. In the first case fluid accumulation occurred after the second caesarean delivery while in our case after the first caesarean delivery.11 In both cases the cause was not identified. Also in this case report, caesarean delivery was performed on maternal request. These days primary caesarean deliveries are generally accepted as nearly risk-free operations.20 In the United States a major factor encouraging caesarean delivery is its increased safety.21 This perception is in contrast to our case report, in which serious and life-threatening complications occurred after elective caesarean delivery. The overall rate of complications after caesarean delivery is 8.1%.22 Our case emphasizes the importance of performing caesarean delivery only when the benefits to be accrued outweigh the potential risks.23 Performing a caesarean delivery on maternal request is medically and ethically acceptable.24 Physicians, however, should, in the absence of an accepted medical indication, recommend against medically unindicated caesarean delivery.24
UK O&G trainees’ attitudes to caesarean delivery for maternal request
Published in Journal of Obstetrics and Gynaecology, 2018
Mehrnoosh Aref-Adib, Evangelia Vlachodimitropoulou, Rajvinder Khasriya, Benjamin W. Lamb, Dan Selo-Ojeme
Over the past 30 years, the rate of the caesarean section (CS) in the UK has tripled and currently accounts for 25% of all deliveries (The Health and Social Care Information Centre 2012). This trend is seen worldwide, and exceeds the WHO recommendation that less than 15% of deliveries should be via caesarean, as levels above this are considered to incur financial burdens and excess clinical risk (World Health Organization 1985; Li et al. 2012). Caesarean delivery for maternal request (CDMR) is defined as a primary pre-labour caeserean in the absence of any maternal or foetal indications (American College of Obstetrics and Gynaecology 2013). Currently, it is estimated that 6–8% of all primary caesareans in the UK are at maternal request (D'Souza and Arulkumaran 2013). Existing evidence from both retrospective and prospective studies is limited: different definitions of ‘maternal request’ are used amongst studies, and reported rates vary widely between 1% and 48% in public sector healthcare systems, and 60% in the private sector (Declercq et al. 2002).