The effects of previous cesarean deliveries on severe maternal and adverse perinatal outcomes at a university hospital in Tanzania - HHM

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Friday, 15 January 2016

The effects of previous cesarean deliveries on severe maternal and adverse perinatal outcomes at a university hospital in Tanzania

Helena Litorp, Mattias Rööst, Hussein L. Kidanto, Lennarth Nyström, Birgitta Essén


Objective of the research was to investigate if multiparous individuals who had undergone a previous cesarean delivery experienced an increased risk of severe maternal outcomes or adverse perinatal outcomes compared with multiparous individuals who had undergone previous vaginal deliveries.

The researchers used an analytical cross-sectional study at a university hospital in Dar es Salaam, Tanzania, enrolled multiparous participants of at least 28 weeks of pregnancy between February 1 and June 30, 2012. Data were collected from patients’ medical records and the hospital's obstetric database. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to compare outcomes among patients who had or had not undergone previous cesarean deliveries.

Results of the research showed a total of 2478 patients were enrolled. A previous cesarean delivery resulted in no increase in the risk of severe maternal outcomes (OR 0.86, 95% CI 0.58–1.26; P = 0.46), and decreased risk of stillbirth (OR 0.42, 95% CI 0.29–0.62, P < 0.001), and intrapartum stillbirth and neonatal distress (OR 0.58, 95% CI 0.38–0.87, P = 0.007).

Previous cesarean delivery was not a risk factor for severe maternal outcomes or adverse perinatal outcomes. The present study was conducted at a referral institution, where individuals with previous cesarean deliveries may constitute a healthy group. Additionally, there could be differences between the study groups in terms of healthcare-seeking behavior, referral mechanisms, intrapartum monitoring, and clinical decision making.

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