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Caesarean Section Versus Vaginal Delivery in Singletons with Preterm Labour - Prospective Cohort Study

Rahul Mansing Kadam, Consultant Neonatologist, Lotus Hospitals for Women and Children, Lakdikapul,Hyderabad, Telangana 50004, India. , Rahul Mansing Kadam1 , Prasad V.S.V.2

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Indian Journal of Maternal-Fetal & Neonatal Medicine 5(2):p 169-174, Jul-Dec 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.5218.7

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Abstract

Background: Subset of cases of preterm birth are because of preterm onset of labour pains in mother with no obvious risk factors. The optimal mode of delivery for women with preterm onset of labour without any obvious risk factor is controversial. Aim: To assess the outcome of newborns born by caesarean delivery versus vaginal birth for women with preterm onset of labour pains with no other risk factors. Settings and design: This prospective cohort study was conducted in a level III neonatal unit of a teaching hospital. Methods and material: Infants included in the study were all preterm babies less than 37 weeks of gestation, born to mother with preterm onset of labour pains without any obvious risk factors and admitted to neonatal unit within 48 hours of life. Exclusion criteria included infants with congenital malformations, multifetal gestation and infants born to mother with any bad obstetric history apart from preterm onset of labour pains. Our primary outcome measures were incidence of birth injury to the infant and birth asphyxia. Results: Incidence of birth injury, birth asphyxia, perinatal death and neonatal mortality was more in vaginal delivery group. However, there was no significant statistical difference between the two groups. Conclusions: We believe that planned caesarean section cannot be recommended as the routine mode of delivery in cases of preterm onset of labour without any other risk factors unless there are other recognized maternal or fetal indications.

Keywords: Birth Asphyxia; Birth Injury; Planned Caesarean Section; Preterm Labour; Vaginal Delivery.   


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DOI: DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.5218.7

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