AsianScientist (Mar. 21, 2012) – A major national study led by the University of Adelaide has found that women who have had one prior caesarean can lower the risk of death and serious complications for their next baby – and themselves – by electing to have another caesarean.
The study, known as the Birth After Caesarean (BAC) study and published in PLoS Medicine, is the first of its kind in the world. It involved more than 2,300 women and their babies and 14 Australian maternity hospitals.
Following a prior caesarean, the study showed that the risk of death or serious complication for the next baby is 2.4 percent for a planned vaginal birth, significantly higher than 0.9 percent for a planned elective repeat caesarean.
The mothers of these babies are also themselves more likely to experience serious complications with a vaginal birth procedure. For example, the risk of a major hemorrhage in the mother is 2.3 percent for a planned vaginal birth, compared with 0.8 percent for a planned elective repeat caesarean.
“Until now there has been a lack of high-quality evidence comparing the benefits and harms of the two planned modes of birth after previous caesarean,” said the study leader, Professor Caroline Crowther from the Australian Research Center for the Health of Women and Babies (ARCH) at the University of Adelaide’s Robinson Institute.
“The information from this study will help women, clinicians, and policy makers to develop health advice and make decisions about care for women who have had a previous caesarean,” she said.
Crowther added that the risks for both mother and infant remain very small for either mode of birth in Australia.
Caesarean section is one of the most common operations performed on childbearing women, with rates continuing to rise worldwide. In 2008, more than 90,700 Australian women gave birth by caesarean, accounting for more than 31 percent of all births. Of this group, 83.2 percent had a further caesarean for the birth of their next child.
“We hope that future research will follow up mothers and children involved in this study, so that we can assess any longer term effects of planned mode of birth after caesarean on later maternal health, and the children’s growth and development,” Crowther said.
The article can be found at: Crowther CA et al. (2012) Planned Vaginal Birth or Elective Repeat Caesarean: Patient Preference Restricted Cohort with Nested Randomised Trial.
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Source: University of Adelaide.
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