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Gao Y, Liu G, Kong P, Song Y, Zhang D, Yin Y, Han M. Smooth muscle 22α deficiency impairs oxytocin-induced uterine contractility in mice at full-term pregnancy. Biochem Biophys Res Commun 2020; 529:884-889. [PMID: 32819594 DOI: 10.1016/j.bbrc.2020.05.220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/30/2020] [Indexed: 11/18/2022]
Abstract
Smooth muscle 22α (SM22α, namely Transgelin), as an actin-binding protein, regulates the contractility of vascular smooth muscle cells (VSMCs) by modulation of the stress fiber formation. However, little is known about the roles of SM22α in the regulation of uterine contraction during parturition. Here, we showed that contraction in response to oxytocin (OT) was significantly decreased in the uterine muscle strips from SM22α knockout (Sm22α-KO) mice, especially at full-term pregnancy, which may be resulted from impaired formation of stress fibers. Furthermore, serious mitochondrial damage such as the mitochondrial swelling, cristae disruption and even disappearance were observed in the myometrium of Sm22α-KO mice at full-term pregnancy, eventually resulting in the collapse of mitochondrial membrane potential and impairment in ATP synthesis. Our data indicate that SM22α is necessary to maintain uterine contractility at delivery in mice, and acts as a novel target for preventive or therapeutic manipulation of uterine atony during parturition.
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MESH Headings
- Adenosine Triphosphate/deficiency
- Animals
- Female
- Gene Expression Regulation
- Mice
- Mice, Knockout
- Microfilament Proteins/deficiency
- Microfilament Proteins/genetics
- Mitochondria/drug effects
- Mitochondria/genetics
- Mitochondria/metabolism
- Mitochondrial Swelling/genetics
- Muscle Proteins/deficiency
- Muscle Proteins/genetics
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Myometrium/drug effects
- Myometrium/metabolism
- Myometrium/pathology
- Oxytocin/pharmacology
- Parturition
- Pregnancy
- Primary Cell Culture
- Stress Fibers/drug effects
- Stress Fibers/metabolism
- Stress Fibers/pathology
- Tissue Culture Techniques
- Uterine Contraction/drug effects
- Uterine Inertia/genetics
- Uterine Inertia/metabolism
- Uterine Inertia/pathology
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Affiliation(s)
- Yakun Gao
- Department of Biochemistry and Molecular Biology, College of Basic Medicine, Key Laboratory of Medical Biotechnology of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Guixia Liu
- Department of Pathogenic Biology, Hebei Medical University, Shijiazhuang, China
| | - Peng Kong
- Department of Biochemistry and Molecular Biology, College of Basic Medicine, Key Laboratory of Medical Biotechnology of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Yu Song
- Department of Biochemistry and Molecular Biology, College of Basic Medicine, Key Laboratory of Medical Biotechnology of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Dandan Zhang
- Department of Biochemistry and Molecular Biology, College of Basic Medicine, Key Laboratory of Medical Biotechnology of Hebei Province, Hebei Medical University, Shijiazhuang, China
| | - Yajuan Yin
- The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Mei Han
- Department of Biochemistry and Molecular Biology, College of Basic Medicine, Key Laboratory of Medical Biotechnology of Hebei Province, Hebei Medical University, Shijiazhuang, China.
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Morton R, Burton AE, Kumar P, Hyett JA, Phipps H, McGeechan K, de Vries BS. Cesarean delivery: Trend in indications over three decades within a major city hospital network. Acta Obstet Gynecol Scand 2020; 99:909-916. [PMID: 31976544 DOI: 10.1111/aogs.13816] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/23/2019] [Accepted: 01/08/2020] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The cesarean delivery rate has been increasing globally in recent decades. The reasons for this are complex and subject to ongoing debate. Investigation of the indications for cesarean delivery and how these have changed over an extended period of time could provide insight into the reasons for changing obstetric practice. Our objective was to explore contributing factors to the increasing rate of cesarean delivery by examining the incidence of and indications for cesarean delivery over the past three decades at our institutions. MATERIAL AND METHODS We conducted a retrospective observational study of all cesarean deliveries, from 24 weeks' gestational age onwards, within an inner-city hospital network in Sydney, Australia, between August 1989 and December 2016. The primary outcome measures were the rates of and indications for emergency and planned cesarean delivery. We also examined our data within the Robson 10-Group Classification system. RESULTS There were 147 722 births over the study period, with 37 309 cesarean deliveries for an overall rate of 25.3%. The rate of cesarean delivery increased from 18.7% in 1989-1994 (8.7% emergency, 10% planned) to 30.4% in 2010-2016 (11.4% emergency, 19% planned). Emergency cesarean delivery for slow progress increased from 3.4% to 5.5% of all births (a relative increase of 62%) and other emergency cesareans mainly performed for suspected intrapartum fetal compromise increased from 5.2% to 5.6% (a relative increase of 8%). Previous uterine surgery (predominantly cesarean section) was the largest contributor to the increase in planned procedures from 3.8% to 9.0% of all births, and 29% of all cesarean deliveries. Primary cesarean delivery for planned antenatal fetal indications, previous pregnancy problems, multiple gestation and maternal choice all increased substantially in combined rate from 0.7% to 4.9%. Cesarean rates in Robson groups 6, 7 and 8 (term breech and multiple gestations) increased most over time. CONCLUSIONS The increased rate of cesarean delivery is mainly attributable to a greater number of procedures performed for slow progress in labor, breech presentation or repeat cesarean section.
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Affiliation(s)
- Rhett Morton
- RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | | | - Praneel Kumar
- RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Jon Anthony Hyett
- RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Hala Phipps
- RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Kevin McGeechan
- Faculty of Medicine and Health, The University of Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
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Genuttis N, Bolz M, Briese V. Can the Rate of C-sections Performed in a Level I Perinatal Center Be Reduced? - An Analysis of the University Gynecology Clinic Rostock, 2008 - 2014. Geburtshilfe Frauenheilkd 2017; 77:771-779. [PMID: 28757656 PMCID: PMC5514020 DOI: 10.1055/s-0043-112863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 04/23/2017] [Accepted: 06/01/2017] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION In Germany the rate of deliveries by cesarean section is continually increasing. Many different reasons have been put forward to explain this trend. The aim of this study was to examine how the C-section rate developed at the University Gynecology Clinic Rostock, one of the biggest maternity hospitals and level I perinatal centers in Germany, based on various maternal and neonatal parameters. The aim was also to identify potential risk factors for C-sections. MATERIAL AND METHOD Various obstetric parameters were obtained from the birth cohort (2008 to 2014; n = 20 091) of the University Gynecology Clinic Rostock. The data was used to calculate parameter-specific C-section rates. Potential risk factors for C-section were identified by regression analysis. RESULTS The C-section rate dropped from 26.24% to 23.57%. The rate of repeat C-sections also declined. The mean age of the pregnant women increased. Nevertheless, the frequency of cesarean sections in pregnant women aged more than 35 years declined. Rates of being overweight or obese preconception increased. C-section rates increased as BMI values preconception increased. There was a perceptible trend towards attempting the vaginal delivery of children in breech presentation and of twins. The frequency of depressed neonates after vaginal delivery and after C-section decreased. Rates for mild and advanced acidosis increased after both C-sections and vaginal deliveries. Previous C-section, older maternal age, overweight and obesity prior to conception, breech presentation and multiple pregnancies all increased the risk of cesarean sections. CONCLUSION This study showed that reducing the rates of C-sections without a deterioration in neonatal outcomes can be achieved even in a large maternity hospital that cares for many high-risk pregnancies.
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Affiliation(s)
- Nele Genuttis
- Universitätsfrauenklinik Rostock, Klinikum Südstadt Rostock, Rostock, Germany
| | - Michael Bolz
- Universitätsfrauenklinik Rostock, Klinikum Südstadt Rostock, Rostock, Germany
| | - Volker Briese
- Universitätsfrauenklinik Rostock, Klinikum Südstadt Rostock, Rostock, Germany
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Dokus K, Zubor P, Matasova K, Visnovsky J, Danko J. Impact of fetal pulse oximetry and ST analysis surveillance withdrawal on rates of obstetric surgery and frequency of low birth umbilical artery pH: a cause of rising caesarean rates? J OBSTET GYNAECOL 2014; 33:685-8. [PMID: 24127954 DOI: 10.3109/01443615.2013.817978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A retrospective observational study on a sample of 13,413 deliveries analysed the effect of a withdrawal of the CTG additional diagnostic methods of fetal hypoxia (fetal pulse oximetry and ST analysis of the fetal ECG) on operative delivery rates and frequency of the umbilical arterial pH < 7.15. Following the withdrawal, obstetricians are more likely to perform caesarean sections for fetal hypoxia (OR 2.23, 95% CI 1.94-2.55, p < 0.0001) and labour dystocia (OR 1.45, 95% CI 1.18-1.77, p = 0.0003), which increases the overall caesarean rate (OR 1.49, 95% CI 1.38-1.61, p < 0.0001), although decreases the incidence of birth umbilical arterial pH < 7.15 (OR 0.43, 95% CI 0.22-0.85, p = 0.015). This also leads to the significant decline in overall frequency of instrumental vaginal deliveries (OR 0.58, 95% CI 0.48-0.71). In order to decrease the overall caesarean rate, obstetricians need to be supported by more accurate and possibly automated diagnostic tools for intrapartum fetal hypoxia.
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Affiliation(s)
- K Dokus
- Department of Obstetrics and Gynecology
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Räisänen S, Gissler M, Kramer MR, Heinonen S. Influence of delivery characteristics and socioeconomic status on giving birth by caesarean section - a cross sectional study during 2000-2010 in Finland. BMC Pregnancy Childbirth 2014; 14:120. [PMID: 24678806 PMCID: PMC3999387 DOI: 10.1186/1471-2393-14-120] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 03/26/2014] [Indexed: 11/10/2022] Open
Abstract
Background Caesarean section (CS) rates especially without medical indication are rising worldwide. Most of indications for CS are relative and CS rates for various indications vary widely. There is an increasing tendency to perform CSs without medical indication on maternal request. Women with higher socioeconomic status (SES) are more likely to give birth by CS. We aimed to study whether giving birth by CS was associated with SES and other characteristics among singleton births during 2000–2010 in Finland with publicly funded health care. Methods Data were gathered from the Finnish Medical Birth Register. The likelihood of giving birth by CS according to CS type (planned and non-planned), parity (nulliparous vs. multiparous), socio-demographic factors, delivery characteristics and time periods (2000–2003, 2004–2007 and 2008–2010) was determined by using logistic regression analysis. SES was classified as upper white collar workers (highest SES), lower white collar workers, blue collar workers (lowest SES), others (all unclassifiable cases) and cases with missing information. Results In total, 19.8% (51,511 of 259,736) of the nulliparous women and 13.1% (47,271 of 360,727) of the multiparous women gave birth by CS. CS was associated with several delivery characteristics, such as placental abruption, placenta previa, birth weight and fear of childbirth, among both parity groups. After adjustment, the likelihood of giving birth by planned CS was reduced by 40% in nulliparous and 55% in multiparous women from 2000–2003 to 2008–2010, whereas the likelihood of non-planned CSs did not change. Giving birth by planned and non-planned CS was up to 9% higher in nulliparous women and up to 17% higher in multiparous women in the lowest SES groups compared to the highest SES group. Conclusions Giving birth by CS varied by clinical indications. Women with the lowest SES were more likely to give birth by CS, indicating that the known social disparity in pregnancy complications increases the need for operative deliveries in these women. Overall, the CS policy in Finland shows favoring a trial of labor over planned CS and reflects no inequity in healthcare services.
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Affiliation(s)
- Sari Räisänen
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA, USA.
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Mittal S, Pardeshi S, Mayadeo N, Mane J. Trends in cesarean delivery: rate and indications. J Obstet Gynaecol India 2014; 64:251-4. [PMID: 25136169 DOI: 10.1007/s13224-013-0491-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 11/11/2013] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To compare the cesarean delivery rates over the last decade and to examine the indications contributing to changed trends, if any. METHODS To compare the rate and indications of cesarean delivery over the last decade, the data were collected in a retrospective manner from all the deliveries that occurred between January 1 and December 31 in 2001, 2006, and 2011, in the department of obstetrics and gynecology, Seth G.S. Medical College and K.E.M. Hospital, a large tertiary care municipal hospital in Western India. A cohort of 20853 delivered women was studied. The rates and indications of primary and repeat cesarean sections were analyzed among the live births to estimate the relative contribution of each indication to the overall increase in rate. RESULTS The cesarean delivery rate increased from 171.70 to 289.30 per 1,000 live births, with an increase in primary cesarean delivery rate from 118.53 (69.03 %) in 2001 to 210.09 (72.62 %) in 2011 per 1,000 live births. Fetal distress, arrest of descent, multiple gestations, and fetal indications contributed to this increase. CONCLUSIONS There is a significant increase in the total cesarean rate with primary cesarean accounting for most of the increase.
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Affiliation(s)
- Shiba Mittal
- Seth G.S. Medical College & K.E.M. Hospital, 602/3-C, Samrudhhi CHS, Vaishali Nagar, K.K. Marg, Jacob Circle, Mahalaxmi (East), Mumbai, 400011 India
| | - Sachin Pardeshi
- Seth G.S. Medical College & K.E.M. Hospital, 602/3-C, Samrudhhi CHS, Vaishali Nagar, K.K. Marg, Jacob Circle, Mahalaxmi (East), Mumbai, 400011 India
| | - Niranjan Mayadeo
- Seth G.S. Medical College & K.E.M. Hospital, 602/3-C, Samrudhhi CHS, Vaishali Nagar, K.K. Marg, Jacob Circle, Mahalaxmi (East), Mumbai, 400011 India
| | - Janki Mane
- Seth G.S. Medical College & K.E.M. Hospital, 602/3-C, Samrudhhi CHS, Vaishali Nagar, K.K. Marg, Jacob Circle, Mahalaxmi (East), Mumbai, 400011 India
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Fruscalzo A, Londero AP, Salvador S, Bertozzi S, Biasioli A, Della Martina M, Driul L, Marchesoni D. New and old predictive factors for breech presentation: our experience in 14 433 singleton pregnancies and a literature review. J Matern Fetal Neonatal Med 2013; 27:167-72. [PMID: 23688372 DOI: 10.3109/14767058.2013.806891] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Breech presentation represents a common indication for primary cesarean section in women presenting for parturition. This study aims to investigate the presence of new and old risk factors for breech presentation and to provide a literature review. METHOD In this population-based retrospective cohort study, we collected data from 14,433 consecutive singleton deliveries occurred in a 3rd level hospital setting of northeast Italy between January 2001 and July 2009. Related risk factors and trends in breech presentation prevalence were also considered. RESULTS Mean maternal age was 31.78 years (±5.17) and mean gestational age at delivery 38.67 weeks (±2.54). Breech presentation prevalence in nullipara and pluripara was respectively 5.36% (415/7743) and 3.53% (236/6689; p<0.05), and was significantly lower among Sub-Saharan-African women 2.62% (14/535) versus 4.51% (651/14432; p<0.05). Also advanced maternal age, early gestational age at delivery, neonatal female gender and low weight at delivery resulted associated with a higher prevalence of breech presentation. By multivariate logistic regression, the breech presentation resulted independently predicted by maternal age, ethnicity, parity, gestational age and neonatal weight MoMs at delivery, and neonatal gender. CONCLUSIONS Advanced maternal age, early gestational age, low neonatal weight MoMs at delivery and female gender resulted to be risk factors for fetal breech presentation at delivery, while multiparity and Sub-Saharan-African ethnicity resulted to be protective.
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Wu Z, Aron AW, Macksoud EE, Iozzo RV, Hai CM, Lechner BE. Uterine dysfunction in biglycan and decorin deficient mice leads to dystocia during parturition. PLoS One 2012; 7:e29627. [PMID: 22253749 PMCID: PMC3258236 DOI: 10.1371/journal.pone.0029627] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 12/01/2011] [Indexed: 02/05/2023] Open
Abstract
Cesarean birth rates are rising. Uterine dysfunction, the exact mechanism of which is unknown, is a common indication for Cesarean delivery. Biglycan and decorin are two small leucine-rich proteoglycans expressed in the extracellular matrix of reproductive tissues and muscle. Mice deficient in biglycan display a mild muscular dystrophy, and, along with mice deficient in decorin, are models of Ehlers-Danlos Syndrome, a connective tissue anomaly associated with uterine rupture. As a variant of Ehlers-Danlos Syndrome is caused by a genetic mutation resulting in abnormal biglycan and decorin secretion, we hypothesized that biglycan and decorin play a role in uterine function. Thus, we assessed wild-type, biglycan, decorin and double knockout pregnancies for timing of birth and uterine function. Uteri were harvested at embryonic days 12, 15 and 18. Nonpregnant uterine samples of the same genotypes were assessed for tissue failure rate and spontaneous and oxytocin-induced contractility. We discovered that biglycan/decorin mixed double-knockout dams displayed dystocia, were at increased risk of delayed labor onset, and showed increased tissue failure in a predominantly decorin-dependent manner. In vitro spontaneous uterine contractile amplitude and oxytocin-induced contractile force were decreased in all biglycan and decorin knockout genotypes compared to wild-type. Notably, we found no significant compensation between biglycan and decorin using quantitative real time PCR or immunohistochemistry. We conclude that the biglycan/decorin mixed double knockout mouse is a model of dystocia and delayed labor onset. Moreover, decorin is necessary for uterine function in a dose-dependent manner, while biglycan exhibits partial compensatory mechanisms in vivo. Thus, this model is poised for use as a model for testing novel targets for preventive or therapeutic manipulation of uterine dysfunction.
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Affiliation(s)
- Zhiping Wu
- Department of Pediatrics, Women and Infants' Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Abraham W. Aron
- Department of Pediatrics, Women and Infants' Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Elyse E. Macksoud
- Department of Pediatrics, Women and Infants' Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Renato V. Iozzo
- Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Chi-Ming Hai
- Department of Molecular Pharmacology, Physiology, and Biotechnology, Brown University, Providence, Rhode Island, United States of America
| | - Beatrice E. Lechner
- Department of Pediatrics, Women and Infants' Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
- * E-mail:
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Osava RH, Silva FMBD, Tuesta EF, Oliveira SMJVD, Amaral MCED. Caracterização das cesarianas em centro de parto normal. Rev Saude Publica 2011; 45:1036-43. [DOI: 10.1590/s0034-89102011000600005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Accepted: 05/17/2011] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Estimar a prevalência de cesarianas em um centro de parto normal intra-hospitalar e identificar fatores associados. MÉTODOS: Estudo transversal com análise de prontuários de 2.441 partos assistidos em março e abril de 2005 em um centro de parto normal intra-hospitalar de São Paulo, SP. A variável dependente (tipo de parto) foi classificada como parto normal e operação cesariana. As variáveis independentes foram categorizadas em quatro grupos: demográficas; história obstétrica pregressa e atual; assistência intraparto; e resultados perinatais. A razão de prevalência e o intervalo de 95% de confiança (IC95%) foram calculados para identificar associação entre tipo de parto e variáveis maternas e do recém-nascido. RESULTADOS: Do total de partos, 14,9% foram operações cesarianas. Ter sido submetida a cesariana na gestação atual esteve associado a cesariana em gestação anterior (RP = 3,19; IC95%: 2,64;3,84), idade gestacional > 40 semanas (RP = 1,32; IC95%: 1,09;1,61), ser admitida com cervicodilatação até 4 cm (RP = 3,22; IC95%: 2,31;4,50), líquido amniótico meconial (RP = 2,5; IC95%: 2,05;3,06). Quanto ao recém-nascido, a cesariana associou-se a peso > 4kg (RP = 1,86; IC95%: 1,29;2,66). Entre as mulheres com cesariana em gestação anterior, ter também parto normal prévio foi fator de proteção para cesariana na gestação atual (RP = 0,46; IC95% 0,30;0,71). Fatores relacionados à condição fetal, como estresse fetal, líquido amniótico meconial, apresentação pélvica e macrossomia corresponderam a 47,8% (175) das indicações para a realização da cesariana; condições ligadas ao mecanismo do parto, como parada de progressão, distócia funcional e distócia de rotação totalizaram 31,3% (115) das indicações. CONCLUSÕES: A prevalência de cesariana mostrou-se dentro dos limites propostos pela Organização Mundial da Saúde. Mulheres com cesariana em gestação anterior, admitidas com até 4 cm de dilatação, idade gestacional > 40 semanas, com líquido amniótico meconial e recém-nascido > 4 kg tiveram maior risco para cesariana.
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Vivian-Taylor J, Sheng J, Hadfield RM, Morris JM, Bowen JR, Roberts CL. Trends in obstetric practices and meconium aspiration syndrome: a population-based study. BJOG 2011; 118:1601-7. [DOI: 10.1111/j.1471-0528.2011.03093.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Amarin Z, Khader Y, Okour A, Jaddou H, Al-Qutob R. National maternal mortality ratio for Jordan, 2007-2008. Int J Gynaecol Obstet 2011; 111:152-6. [PMID: 20810108 DOI: 10.1016/j.ijgo.2010.05.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 05/26/2010] [Accepted: 06/16/2010] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To estimate the number of maternal deaths per 100000 live births during 2007-2008 among Jordanian women; to identify the causes of maternal mortality; and to compare the results with those of the last report for 1995-1996. METHODS Reproductive-age mortality study of maternal deaths among women aged 15-49 years in Jordan in 2007-2008. RESULTS Among 1406 identified deaths of reproductive-aged women, 76 maternal deaths were identified out of 397588 live births, for a maternal mortality ratio of 19.1 deaths per 100000 live births. Forty-three (56.6%) deaths were attributable to hemorrhage, thrombosis and thromboembolism, and sepsis. Avoidable factors were present in 53.9% of women, 52.6% had substandard care, and 31.5% had 3 or fewer antenatal visits. Of those with available information on family planning, only 29.4% had ever used any form of contraception. CONCLUSIONS Maternal deaths in Jordan are declining. The maternal mortality ratio of 19.1 deaths per 100000 live births reported for 2007-2008 showed a remarkable reduction of 53.9% achieved in the 12 years since the 1995-1996 report (a 4.5% annual reduction), which is approaching the 75% reduction recommended by Millennium Development Goal 5.
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Affiliation(s)
- Zouhair Amarin
- Jordan University of Science and Technology, Irbid, Jordan.
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