Does discussion of possible scar rupture influence preferred mode of delivery after a caesarean section?
Using retrospective and prospective analyses of antenatal records, it was found that by 2003, discussions about the options for delivery after one lower segment caesarean section (LSCS) were almost always documented in antenatal notes, compared with only rare entries in 1993; specific mention of the risks of scar rupture were made in just under 50% in 2003. There was a considerable reduction in the proportion of women whose preference was to labour in 2003 compared with 1993 and also in the number who ultimately delivered vaginally. There was, however, no evidence that those women with whom possible scar rupture had been discussed were discouraged from attempting vaginal delivery. These data suggest that, contrary to expectations, increasing patients' involvement in their management in this situation does not result in fewer caesarean sections.
Sur
Shyamaly
S
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Oxford, UK.
Mackenzie
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IZ
D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000150:complications*; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011247:Pregnancy; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D014597:Uterine Rupture; D016064:Vaginal Birth after Cesarean