BJOG : an international journal of obstetrics and gynaecology
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To estimate the incidence of multiple repeat caesarean section (MRCS) (five or more) in the UK and to describe the outcomes for women and their babies relative to women having fewer repeat caesarean sections. ⋯ MRCS is associated with greater maternal and neonatal morbidity than fewer caesarean sections. The associated maternal morbidity is largely secondary to placenta praevia and accreta, whereas higher rates of preterm delivery are most likely a response to antepartum haemorrhage.
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To investigate persistent faecal incontinence (FI) 12 years after birth and association with delivery mode history and quality of life. ⋯ This longitudinal study has demonstrated persistence of FI many years after birth and shown that one forceps birth increased the likelihood, whereas exclusive caesarean birth showed no association. Obesity, which increased symptom likelihood, is a modifiable risk factor.
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Comparative Study
International comparisons of preterm birth: higher rates of late preterm birth are associated with lower rates of stillbirth and neonatal death.
To examine international rates of preterm birth and potential associations with stillbirths and neonatal deaths at late preterm and term gestation. ⋯ Countries with high rates of preterm birth at 32-36 weeks of gestation have lower stillbirth and neonatal death rates at and beyond 32 weeks of gestation. Contemporary rates of preterm birth are indicators of both perinatal health and obstetric care services.
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To describe a large study on pregnancy outcome after vaccination against H1N1 during the 2009/10 pandemic. ⋯ Vaccination during pregnancy with Pandemrix(®) appeared to have no ill effects on the pregnancy. On the contrary, the rate of preterm birth and low birthweight was lower than expected, which agrees with some previous results.
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Randomized Controlled Trial Comparative Study
Effects of continuity of care by a primary midwife (caseload midwifery) on caesarean section rates in women of low obstetric risk: the COSMOS randomised controlled trial.
To determine whether primary midwife care (caseload midwifery) decreases the caesarean section rate compared with standard maternity care. ⋯ In settings with a relatively high baseline caesarean section rate, caseload midwifery for women at low obstetric risk in early pregnancy shows promise for reducing caesarean births.