American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Oct 2001
Comparative StudyIncreased risk of cesarean delivery with advancing maternal age: indications and associated factors in nulliparous women.
To investigate factors that contribute to the increased risk of cesarean delivery with advancing maternal age. ⋯ Older women are at higher risk for cesarean delivery in part because they are more likely to have cesarean delivery without labor. However, even among those women who labor, older women are more likely to undergo cesarean delivery, regardless of whether labor is spontaneous or induced. Part of the higher rate among older women who labor is explained by a higher rate of induction, particularly elective induction. Among women in both spontaneous and induced labor, cesarean delivery for the diagnoses of failure to progress and fetal distress was more frequent in older patients, although management of labor dystocia for these patients was similar to that for younger patients.
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Am. J. Obstet. Gynecol. · Oct 2001
Comparative StudyOutcomes of trial of labor following previous cesarean delivery among women with fetuses weighing >4000 g.
To compare outcomes at term of a trial of labor in women with previous cesarean delivery who delivered neonates weighing > 4000 g versus women with those weighing < or = 4000 g. ⋯ A trial of labor after previous cesarean delivery may be a reasonable clinical option for pregnant women with suspected birth weights of > 4000 g, given that the rate of uterine rupture associated with these weights does not appear to be substantially increased when compared to lower birth weights. However, some caution may apply when considering a trial of labor in women with infants weighing > 4250 g. In these women with infants weighing > 4000 g, the likelihood of successful vaginal delivery, although lower than for neonates weighing < or = 4000 g, is still 60%.
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Am. J. Obstet. Gynecol. · Oct 2001
Comparative StudyInfertility treatment is an independent risk factor for cesarean section among nulliparous women aged 40 and above.
To determine whether nulliparous women > 40 years old with singleton pregnancies who conceived after infertility treatment are at an increased risk for cesarean section compared with older nulliparous patients who conceived spontaneously. ⋯ A history of infertility treatment among nulliparous women > 40 years old with singleton pregnancies increases the risk for cesarean delivery independently of other known risk factors.
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Am. J. Obstet. Gynecol. · Oct 2001
Comparative StudyAre women who are Jehovah's Witnesses at risk of maternal death?
The purpose of this study was to determine the rates of obstetric hemorrhage and maternal mortality in women who are Jehovah's Witnesses and to evaluate a protocol that uses erythropoietin to optimize the red blood cell mass before delivery. ⋯ Women who are Jehovah's Witnesses are at a 44-fold increased risk of maternal death, which is due to obstetric hemorrhage. Patients should be counseled about this risk of death, and obstetric hemorrhage should be aggressively treated, including a rapid decision to proceed to hysterectomy when indicated.
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Am. J. Obstet. Gynecol. · Oct 2001
Comparative StudyObstetrical intervention rates and maternal and neonatal outcomes of women with gestational hypertension.
The purpose of this study was to determine the obstetrical intervention rates and maternal and neonatal outcomes of women with gestational hypertension. ⋯ Women with gestational hypertension had obstetrical intervention rates much higher than control subjects and similar to those with preeclampsia and chronic hypertension.