The objective of this article is to determine through meta-analysis of published literature whether active management of labor lowers the cesarean delivery rate for dystocia in nulliparas. Using MEDLINE and reference citations to 1966, 18 published reports in English on active management of labor were identified. Selection criteria for five selected studies included: tenets of active management...

BACKGROUND Cesarean birth is associated with altered composition of the neonate's microbiota and with increased risk for obesity and other diseases later in life. The mechanisms of these associations, and whether cesarean birth is associated with an altered adult microbiota, are unknown. METHODS In 1097 adult volunteers without diabetes, inflammatory bowel disease, or recent antibiotic use, f...

OBJECTIVE To determine the effects of elective induction on the risk of cesarean delivery in a cohort of women with low-risk term pregnancies and to evaluate the costs of elective induction services within our hospital system. METHODS Records of 1135 eligible women with low-risk, singleton, vertex pregnancies at 38-41 weeks' gestation who were eligible for vaginal delivery were analyzed retro...

OBJECTIVE To determine if the history of cesarean section was associated with chronic pelvic pain, independent of the presence of other conditions such as pelvic adhesions, endometriosis, sequelae of pelvic inflammatory disease, leiomyoma and pelvic varices. METHODS Retrospective case-control study conducted on 199 patients consecutively admitted from January 1998 to January 2000, 116 of them...

IMPORTANCE Planned cesarean delivery comprises a significant proportion of births globally, with combined rates of planned and unscheduled cesarean delivery in a number of regions approaching 50%. Observational studies have shown that offspring born by cesarean delivery are at increased risk of ill health in childhood, but these studies have been unable to adjust for some key confounding variab...

INTRODUCTION The practice of cesarean section is known to decrease the occurrence of long bone fractures. We present here an unusual diaphyseal fracture of the femur of a newborn after cesarean section, the only case observed in our 14 years of practice. CASE REPORT The patient was a 3.4-kg female child born at 38 weeks of gestation. The mother was a primipara and aged 39 years. Ultrasound ex...

PURPOSE OF REVIEW We have recently identified three salient questions within the patient choice cesarean delivery controversy. First, is performing cesarean delivery on maternal request consistent with good professional medial practice? Second, how should physicians respond to or counsel patients who request patient choice cesarean delivery? Third, should patient choice cesarean delivery be rou...

Ten pairs of full-term and 8 pairs of preterm twins from combined vaginal and Cesarean section deliveries were evaluated on measures of neonatal temperament, developmental status, and integrity to determine if the Cesarean-delivered infant was compromised relative to its vaginally-delivered twin. There were no significant differences, within groups, between the vaginal and Cesarean section infa...

PURPOSE Cesarean section is the most common surgery performed in obstetrics. Incorporating a simulation model into training provides a safe, low-stress environment in which students can gain skills and receive feedback. The purpose of this study was to determine the effectiveness of obstetrics simulator training for medical students doing their internship. METHODS Twenty-five students posted ...

Cesarean deliveries are widely used in many high- and middle-income countries. This overuse both increases costs and lowers quality of care and is thus a major concern in the healthcare industry. The study first examines the impact of prenatal care utilization on cesarean delivery rates. It then determines whether socioeconomic status affects the use of prenatal care and thereby influences the ...