Peripartum Morbidity after Cesarean Delivery for Arrest of Dilation at 4 to 5 cm Compared with 6 to 10 cm

Am J Perinatol. 2018 Oct;35(12):1173-1177. doi: 10.1055/s-0038-1642063. Epub 2018 Apr 24.

Abstract

Objective: Given that recent consensus guidelines established to decrease cesarean delivery (CD) rates use 6 cm to define the onset of the active phase of labor, our objective was to evaluate maternal and neonatal outcomes after CD for the indication of arrest of dilation at 4 to 5 cm compared with ≥ 6 cm.

Study design: We performed a secondary analysis using data from the Maternal Fetal-Medicine Units Network Cesarean Registry. We included nulliparous women with term, singleton, vertex gestations who underwent primary CD for arrest of dilation. We compared those who reached a maximum cervical dilation of 4 to 5 cm with those of ≥6 cm. Our primary outcome was composite maternal morbidity that included chorioamnionitis, endometritis, transfusion, wound complication, operative injury, intensive care unit admission, or death.

Results: Of the 73,257 women in the dataset, 5,681 met the inclusion criteria. After adjusting for confounders, there was no difference in composite maternal (adjusted odds ratio [aOR]: 1.19; 95% confidence interval [CI]: 0.94-1.52) or neonatal morbidity (aOR: 0.94; 95% CI: 0.79-1.10) between the groups.

Conclusion: In this historical cohort, maternal and neonatal outcomes after CD for arrest of dilation ≥ 6 cm were comparable to those performed at 4 to 5 cm and support recent labor management guidelines.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Cesarean Section / statistics & numerical data*
  • Chorioamnionitis / epidemiology*
  • Female
  • Humans
  • Labor Stage, First / physiology*
  • Labor, Induced
  • Logistic Models
  • Morbidity
  • Obstetric Labor Complications / epidemiology*
  • Peripartum Period
  • Practice Guidelines as Topic
  • Pregnancy
  • Prospective Studies
  • ROC Curve
  • Young Adult