Prevention of the first cesarean delivery: the role of operative vaginal delivery.

Abstract:

:While the cesarean delivery (CD) rates have increased worldwide, operative vaginal delivery (OVD) rates continue to decline, with the United States having some of the lower rates amongst developed countries. It is clear that the use of forceps or vacuum can safely assist in accomplishing a vaginal delivery and prevent a cesarean during the IInd stage of labor performed for a variety of maternal or fetal indications. In the absence of randomized trials between OVD's and immediate CD's for anticipated difficult births the question of the balance of risks between the two interventions remains unanswered. Properly performed OVD's are associated with lower maternal morbidity compared with cesarean, without an increase in significant neonatal morbidity. In order to reverse the current trends and for these skills to continue active training in OVD's is clearly needed during and after residency. The availability of clinicians with expertise in OVD's should aid in decreasing the rates of CD and the training of newer generations of practitioners. The professional endorsement of OVD's is also fundamental not only to frame the practice for physicians but to promote and improve the general acceptance of assisted deliveries and facilitate the societal discourse to reduce CD rates.

journal_name

Semin Perinatol

journal_title

Seminars in perinatology

authors

Gei AF

doi

10.1053/j.semperi.2012.04.021

subject

Has Abstract

pub_date

2012-10-01 00:00:00

pages

365-73

issue

5

eissn

0146-0005

issn

1558-075X

pii

S0146-0005(12)00056-0

journal_volume

36

pub_type

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