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Method identifies risk factors for second C-section.(Obstetrics)
The following factors are associated with an increased risk of emergency cesarean section in women who have had a previous cesarean section and are attempting vaginal birth: older maternal age, low maternal height, male gender of baby, labor induced by prostaglandin, not having had a previous vaginal birth, and later birth.
These are the key conclusions of a study that used a new method to predict the risk of failed vaginal birth after a cesarean section.
"There is, at present, no validated method that allows antepartum assessment of the risks of emergency cesarean section, and counseling of women is, at best, semiquantitative," wrote the investigators, who were led by Gordon C.S. Smith, M.B., of the department of obstetrics and gynecology at Cambridge University, United Kingdom. "In the present study, we provide a validated model that classifies over half this population as being low or high risk of emergency cesarean section, on the basis of thresholds suggested by a previous systematic review."
He and his associates studied 23,286 women in Scotland, each of whom had one prior cesarean delivery and who attempted vaginal birth at or after 40 weeks' gestation between 1985 and 2001 (PLoS Med. 2005;2[9]:e252). They randomly divided the women into group 1 (the model development group) and group 2 (the validation group).
In group 1, the investigators tested their method of determining risk of emergency cesarean section by examining various risk factors including the mother's age and height, the sex of the baby, gestational age, and whether and how the birth was induced. When they applied the model ...
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