ABSTRACT
We compared maternal morbidity between planned vaginal and planned cesarean delivery.
A university hospital's database was queried for delivery outcomes. Between 1995 and
2005, 26,356 deliveries occurred. Subjects were divided into two groups: planned vaginal
and planned cesarean delivery. This was based on intent to deliver vaginally or by
cesarean, despite actual route of delivery. Planned vaginal delivery included successful
vaginal delivery and labored cesarean delivery intended for vaginal delivery. Planned
cesarean delivery included unlabored and labored cesarean delivery and vaginal delivery
intended for cesarean. Chart abstraction confirmed the delivery plan. Primary outcomes
were chorioamnionitis, postpartum hemorrhage, and transfusion. Secondary outcomes
were also measured. A subanalysis compared actual vaginal delivery, labored cesarean
delivery, and unlabored cesarean delivery. There were 3868 planned vaginal deliveries
and 180 planned cesarean deliveries. Planned cesarean delivery had less chorioamnionitis
(2.2% versus 17.2%), postpartum hemorrhage (1.1% versus 6.0%), uterine atony (0.6%
versus 6.4%), and prolonged rupture of membranes (2.2% versus 17.5%) but a longer
hospital stay (3.2 versus 2.6 days). There were no differences in transfusion rates.
For healthy primiparous women, planned cesarean delivery decreases certain morbidities.
Labored cesarean delivery had increased risks compared with both vaginal delivery
and unlabored cesarean delivery.
KEYWORDS
Maternal outcomes - planned cesarean delivery - planned vaginal delivery - CDMR
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Elizabeth J GellerM.D.
University of North Carolina at Chapel Hill, Department of Obstetrics and Gynecology
CB #7570, Chapel Hill, NC 27599-7570
Email: egeller@med.unc.edu