Onm-8: Evidence Base for Method of Birth among Women Conceiving with ART (A Systematic Review

Background: The evidence base for childbirth has been progressively developed and refined over several decades. Effective maternity care with least harm is optimal for childbearing women and newborns. High-quality systematic reviews of the best available research provide the most trustworthy knowledge about beneficial and harmful effects of health interventions. The aim of this study was to summarize results of many systematic reviews that could be used to improve childbearing care quality for women, with a focus on opportunities to increase benefit and reduce harm for the childbearing women who convinced by ART and their newborns. Materials and Methods: According a small systematic review, we reviewed more than 15 research study by using peer reviews, west countries guidelines and protocols, update data base and WHO standards. Scrutiny has been limited to method of birth among women conceiving with fertility treatment. Results: Interestingly, data shows that 50 percent of all cesarean sections for term singleton babies were performed at less than 39 weeks. Data were not available on onset of labor or indication for cesarean delivery. We could not determine what proportion of cesarean deliveries was elective arising from medical indications or from the precious baby effect. The literature suggests that a significant reduction in neonatal respiratory morbidity because infants delivered by elective cesarean section at 37 and 38 weeks’ gestation have fivefold and fourfold risks, respectively, of severe respiratory morbidity . Other studies have found excess risk of neonatal mortality among low-risk women with no labor complications who have primary cesarean deliveries compared with planned vaginal births. Conclusion: Almost one-quarter of a million births occurred worldwide after ART, However, scrutiny has been limited to method of birth among women conceiving with fertility treatment internationally and a high acceptability of the use of cesarean delivery. Currently, no international and national practice recommendations are available with respect to method of birth for ART pregnancies. Reliable data on the outcomes of women giving birth after ART are an important part of monitoring the safety and quality of ART pregnancies. This research should stimulate discussion about what clinical parameters should be used in the decision to perform cesarean sections among women giving birth after ART. In particular, greater scrutiny is needed to investigate the indication for and timing of cesarean delivery for term singleton births.