Abstract：
:In 2011, 1 in 3 women who gave birth in the United States did so by cesarean delivery. Cesarean birth can be lifesaving for the fetus, the mother, or both in certain cases. However, the rapid increase in cesarean birth rates from 1996 through 2011 without clear evidence of concomitant decreases in maternal or neonatal morbidity or mortality raises significant concern that cesarean delivery is overused. Variation in the rates of nulliparous, term, singleton, vertex cesarean births also indicates that clinical practice patterns affect the number of cesarean births performed. The most common indications for primary cesarean delivery include, in order of frequency, labor dystocia, abnormal or indeterminate (formerly, nonreassuring) fetal heart rate tracing, fetal malpresentation, multiple gestation, and suspected fetal macrosomia. Safe reduction of the rate of primary cesarean deliveries will require different approaches for each of these, as well as other, indications. For example, it may be necessary to revisit the definition of labor dystocia because recent data show that contemporary labor progresses at a rate substantially slower than what was historically taught. Additionally, improved and standardized fetal heart rate interpretation and management may have an effect. Increasing women's access to nonmedical interventions during labor, such as continuous labor and delivery support, also has been shown to reduce cesarean birth rates. External cephalic version for breech presentation and a trial of labor for women with twin gestations when the first twin is in cephalic presentation are other of several examples of interventions that can contribute to the safe lowering of the primary cesarean delivery rate.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
American College of Obstetricians and Gynecologists (College).,Society for Maternal-Fetal Medicine.,Caughey AB,Cahill AG,Guise JM,Rouse DJdoi
10.1016/j.ajog.2014.01.026subject
Has Abstractpub_date
2014-03-01 00:00:00pages
179-93issue
3eissn
0002-9378issn
1097-6868pii
S0002-9378(14)00055-6journal_volume
210pub_type
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journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90516-4
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abstract：OBJECTIVE:The purpose of this study was to compare maternal characteristics and neonatal morbidity and mortality rates that are associated with early-onset neonatal sepsis that is caused by group B Streptococcus and Escherichia coli. STUDY DESIGN:This was a retrospective review of newborn infants with a positive blood...
journal_title：American journal of obstetrics and gynecology
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abstract：OBJECTIVE:We used validated sensitive and specific questions associated with clinically confirmed diagnoses of unexplained vulvar pain (vulvodynia) to compare the cumulative incidence of vulvar pain and prevalence of care-seeking behavior in Boston metropolitan area (BMA) and in Minneapolis/Saint Paul metropolitan area...
journal_title：American journal of obstetrics and gynecology
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journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(90)91079-r
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journal_title：American journal of obstetrics and gynecology
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pub_type： 杂志文章,评审
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更新日期：2012-03-01 00:00:00
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journal_title：American journal of obstetrics and gynecology
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更新日期：2012-09-01 00:00:00
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journal_title：American journal of obstetrics and gynecology
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doi：10.1016/0002-9378(94)90164-3
更新日期：1994-11-01 00:00:00
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doi：10.1067/mob.2000.108081
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doi：10.1016/j.ajog.2004.06.102
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journal_title：American journal of obstetrics and gynecology
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doi：10.1016/0002-9378(94)90414-6
更新日期：1994-12-01 00:00:00
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journal_title：American journal of obstetrics and gynecology
pub_type： 临床试验,杂志文章
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更新日期：1991-09-01 00:00:00
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pub_type： 杂志文章,评审
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pub_type： 杂志文章
doi：10.1016/0002-9378(76)90902-9
更新日期：1976-05-01 00:00:00
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pub_type： 杂志文章,meta分析
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更新日期：2015-01-01 00:00:00
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journal_title：American journal of obstetrics and gynecology
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journal_title：American journal of obstetrics and gynecology
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journal_title：American journal of obstetrics and gynecology
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doi：
更新日期：1983-02-01 00:00:00
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journal_title：American journal of obstetrics and gynecology
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journal_title：American journal of obstetrics and gynecology
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更新日期：2011-03-01 00:00:00
