Mothering Forum banner

1 - 7 of 7 Posts

·
Registered
Joined
·
501 Posts
Discussion Starter · #1 ·
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Mar 14 (Reuters Health) - The likelihood that a pregnant woman will have to undergo an unplanned c-section delivery after starting labor can be predicted by four parameters, British researchers have shown.<br><br>
Dr. Elisabeth Peregrine and colleagues at the University College London Hospitals studied 267 women at 36 weeks gestation or later who were scheduled for induction of labor. Eighty women (30 percent) ended up having an emergency cesarean.<br><br>
Of all the measures assessed, four factors in particular were strongly tied to the need for a c-section.<br><br>
Having never had a previous pregnancy raised the chances 20-fold. A body mass index over 30 (obese) was tied to 6-fold greater risk, while being tall reduced the chances slightly. Finally, a longer cervix measured by ultrasound was associated with a higher chance of having a cesarean.<br><br>
When these factors were considered together they were "reasonably" accurate in predicting who would undergo a cesarean, Peregrine's team reports in the medical journal Obstetrics and Gynecology.<br><br>
Maternal height and BMI "have been known for a while to influence the risk of cesarean section," Peregrine explained. "However it has been difficult to quantify them and combine them together to provide the woman with useful advice."<br><br>
She also pointed out that measurement of cervical length by ultrasound is not done routinely at the moment, so the obstetrician in routine practice would not have this information.<br><br>
Before the study's findings can be used to counsel women, they need to be validated, she added, and that is under way. If the results prove accurate, women could be told their risk of having an emergency cesarean delivery -- and those at high risk could be offered the chance to have a planned c-section.<br><br>
SOURCE: Obstetrics and Gynecology, February 2006.<br></td>
</tr></table></div>
Ok, these women were INDUCED which means they were at a higher risk for an emergency C-section anyway. So now we will be telling women that because this is their first baby, they ought to just schedule the C section right away. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">:
 

·
Registered
Joined
·
27,052 Posts
Well, they were apparently trying to compensate for the affects of induction by only looking at patients who were induced. Except what that really proves is that inductions are only safe for multiparous, fit women.
 

·
Registered
Joined
·
3,391 Posts
I find the cervical condition and length interesting. (though I think induction in general is the reason for the csections in this article)
 

·
Registered
Joined
·
12,020 Posts
Regardless of the reason, there needs to be fewer scheduled c-sections. Period. Everyone agrees on that except the doctors making a ton of money off of it.
 

·
Registered
Joined
·
4,977 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">women could be told their risk of having an emergency cesarean delivery -- and those at high risk could be offered the chance to have a planned c-section.</td>
</tr></table></div>
<br>
Something about this seems really off but I can't articulate just exactly what it is... but naturally I'll give it a go, lol. I've had both an emergency c/s and a planned one so from that perspective, will share my thoughts as directed towards the study's authors & media that disseminates; not personally directed to anyone here.<br><br>
First, planned c/s still carry risks, and contrary to popular belief, are not automatically easier to recover from. You cannot know if you will have an easy recovery or not. Second, babies benefit from labor and have poorer outcomes with c/s. Third, no mention of what the results indicate about the safety of induction itself, I am bugged by that and the flat assumption that all those planned inductions were medically necessary. It feels skewed to me that while the results tell us something about induction safety, that is ignored and it's being made into another reason to encourage surgical birth simply because there is a chance of surgical birth.<br><br><br>
The bit about cervical length: is this not a variation of normal? Is it possible that a longer cervix might take more time to prepare for delivery, thus pushing a woman out of the comfort zone of the OB's preferred time limits and leading him to call "FTP" or "CPD" or in the future, "ECL" (excessive cervical length)? Therefore increasing the chance of emergency c/s? All purely speculation of course, I am not an expert on anyone's cervix, but I can just see it now, we end up with prenatal u/s for cervical length and advise women if they are "too long". Sounds a lot like "Baby is too big" and "Your pelvis is too small".<br><br>
At any rate, it sounds like a circular argument. If you take the choice of going straight to surgery to avoid the risk of surgery, you've become the embodiment of that risk, it DID happen to you, you did not avoid the c/s.<br><br><br>
The way this is being presented sounds less like a study hoping to provide useful info, and more like a study hoping to create a marketing strategy to "help" more women choose c/s.<br><br>
Didn't a study recently come out showing that contrary to OBs claims, the rise in c/s rates is not actually due to women requesting them? Makes sense that if research shows your product is not being sought by your customers, then your marketing dept. needs to do some work. I can see why then, OBs will want to show justification for women to be offered more and more opportunities to be counseled about electing a c/s.
 

·
Registered
Joined
·
501 Posts
Discussion Starter · #6 ·
<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/yeahthat.gif" style="border:0px solid;" title="yeah that">: Well said.
 

·
Registered
Joined
·
4,432 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">At any rate, it sounds like a circular argument. If you take the choice of going straight to surgery to avoid the risk of surgery, you've become the embodiment of that risk, it DID happen to you, you did not avoid the c/s.</td>
</tr></table></div>
Well put!
 
1 - 7 of 7 Posts
Top