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Public·167 Sugar Warrior

Wondershare Filmora 6 0 2 [WORK]


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Wondershare Filmora 6 0 2 [WORK]


A recent systematic review of the use of cesarean delivery on maternal request for low-risk women and for those with complications will guide future practice. The author(s) find that for low-risk women undergoing a indicated cesarean delivery, vaginal delivery after maternal request may be offered. For women with indications for cesarean delivery, the authors find that a woman should be informed of the risks and benefits of each mode of delivery and provided with evidence-based counseling about her options. For women who request an elective cesarean delivery at term, a delay in delivery beyond 39 weeks or at an estimated date of delivery less than 40 weeks should be considered. For women with fetal indications for cesarean delivery, a vaginally delivered low-risk neonate who weighs more than 2500 grams should be resuscitated and stabilized. When an elective cesarean delivery is indicated, the authors recommend that the primary mode of delivery be determined by patient preference rather than to placate maternalrequest or the perceived superiority of a given mode of delivery. An early plan by the patient and/or her partner to consider the possibility of cesarean delivery should be honored. The cost of this approach must be borne by a patient considering cesarean delivery for reasons other than maternal request. Women with complex medical disorders such as placenta previa, placenta accreta spectrum, and gravid hysterectomy are not candidates for vaginal delivery on maternal request. Finally, for a woman requesting delivery of a breech infant, cesarean delivery on maternal request is safe and appropriate.


A retrospective cohort study, performed at 3 tertiary-referral centers in the Netherlands, examined a total of 3.65 million deliveries from 2006 to 2011. Of these, 4.6% (n=1.83 million) were cesarean deliveries on maternal request. There were no significant differences in the primary outcomes of preterm birth (n=8,500 (4.5%); P=0.54), low birth weight (n=1,808 (1.1%); P=0.24), or neonatal deaths (n=58 (0.03%); P=0.96), between cesarean delivery on maternal request and planned vaginal delivery. The rate of women with significant comorbidities precluding vaginal delivery was 0. d2c66b5586






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