Mothers who opt for elective caesarean instead of vaginal delivery are more likely to have infants with higher rates of respiratory illness, low blood sugar (hypoglycaemia), and need for neonatal intensive care unit (NICU).
Mothers who opt for elective caesarean instead of vaginal delivery after previously undergoing a caesarean are more likely to have infants with higher rates of respiratory illness, low blood sugar (hypoglycaemia), and need for neonatal intensive care unit (NICU).
The controversy remains on whether a trial of labour or an elective repeat caesarean delivery is preferable for a woman with a history of caesarean delivery. Because a failed trial of vaginal delivery carries an increased risk of uterine rupture and impairment of the infant's breathing, obstetricians often favour elective repeat caesarean.
To compare the outcomes of elective caesarean versus vaginal birth after caesarean delivery, researchers from America studied 672 women who had one prior caesarean delivery of a single full-term infant without birth defects. The study was conducted between 2005 and 2008.
The women were categorised into four groups: elective repeat caesarean before labour begins (239 women); elective caesarean after onset of labour (104 women); successful vaginal birth after caesarean (244 women); or failed vaginal birth after caesarean requiring emergency caesarean delivery (85 women).
Overall, it was found that infants delivered by caesarean had significantly higher admission rates to the NICU compared with those delivered vaginally after caesarean (9.3 percent versus 4.9 percent, respectively). Planned repeat caesareans were associated with a higher incidence of NICU admission for treatment of hypoglycaemia and administration of oxygen and ventilatory support.
The researchers theorised that the surge in the chemical compound catecholamine, which occurs during labour, probably plays an important role in clearing fetal lung fluid and controlling blood sugar levels after birth.
More specifically, women who failed vaginal birth and required caesarean delivery were most likely to have an infant that experienced distress requiring resuscitation, whereas a successful vaginal birth after previous caesarean was associated with the lowest rates of admission to the NICU, the shortest hospital stays, and the lowest incidence of ongoing respiratory support.
The above findings argue for greater selectivity in performing a caesarean delivery in the first place, and certainly a greater need for counselling before a primary elective caesarean delivery.
The controversy remains on whether a trial of labour or an elective repeat caesarean delivery is preferable for a woman with a history of caesarean delivery. Because a failed trial of vaginal delivery carries an increased risk of uterine rupture and impairment of the infant's breathing, obstetricians often favour elective repeat caesarean.
To compare the outcomes of elective caesarean versus vaginal birth after caesarean delivery, researchers from America studied 672 women who had one prior caesarean delivery of a single full-term infant without birth defects. The study was conducted between 2005 and 2008.
The women were categorised into four groups: elective repeat caesarean before labour begins (239 women); elective caesarean after onset of labour (104 women); successful vaginal birth after caesarean (244 women); or failed vaginal birth after caesarean requiring emergency caesarean delivery (85 women).
Overall, it was found that infants delivered by caesarean had significantly higher admission rates to the NICU compared with those delivered vaginally after caesarean (9.3 percent versus 4.9 percent, respectively). Planned repeat caesareans were associated with a higher incidence of NICU admission for treatment of hypoglycaemia and administration of oxygen and ventilatory support.
The researchers theorised that the surge in the chemical compound catecholamine, which occurs during labour, probably plays an important role in clearing fetal lung fluid and controlling blood sugar levels after birth.
More specifically, women who failed vaginal birth and required caesarean delivery were most likely to have an infant that experienced distress requiring resuscitation, whereas a successful vaginal birth after previous caesarean was associated with the lowest rates of admission to the NICU, the shortest hospital stays, and the lowest incidence of ongoing respiratory support.
The above findings argue for greater selectivity in performing a caesarean delivery in the first place, and certainly a greater need for counselling before a primary elective caesarean delivery.
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