title: Pregnancy outcome and placental pathology in emergent cesarean deliveries for non-reassuring fetal heart rate in laboring versus non-laboring women.
abstract: The objective of this study is to correlate between pregnancy outcome and placental pathology in emergent cesarean deliveries (ECD) for non-reassuring-fetal-heart-rate (NRFHR) performed in women in their active phase of labor versus those performed in non-laboring women.
  
  
  
  A retrospective cohort study. Data were reviewed for all pregnancies necessitating ECD for NRFHR between January 2009 and December 2013. Maternal outcome, neonatal outcome, and placental pathology parameters were compared between ECDs performed during active phase of labor and those performed before the active phase of labor (non-labor group).
  
  
  
  During the study period, a total of 661 ECDs were performed due to NRFHR. Compared with the active labor group (n = 335), the non-labor group (n = 326) had more pre-eclampsia (p = 0.033), small for gestational age (SGA) (p = 0.016), and preterm labor (p < 0.001). Worse composite neonatal outcome was observed in the non-labor group compared with the active labor group, p < 0.001. By a stepwise logistic regression model, non-labor was independently associated with adverse neonatal outcome (1.88 OR CI; 1.19-2.96, p = 0.007). Placental inflammatory lesions were more common in the active labor group (p= 0.043), and abnormal cord insertions were more common in the non-labor group (p = 0.002) as well as placental weight <10th% (p = 0.019).
  
  
  
  Higher rate of pregnancy complications, abnormal cord insertion, smaller placentas, and worse neonatal outcome are associated with ECD for NRFHR when performed before the phase of active labor.
authors.affiliation: a Department of Obstetrics & Gynecology and.
authors.forename: Eran
authors.initials: E
authors.lastname: Weiner
authors.affiliation: a Department of Obstetrics & Gynecology and.
authors.forename: Nataly
authors.initials: N
authors.lastname: Fainstein
authors.affiliation: a Department of Obstetrics & Gynecology and.
authors.forename: Adam
authors.initials: A
authors.lastname: Pomeranz
authors.affiliation: b Department of Pathology , The Edith Wolfson Medical Center, Holon, Israel Affiliated with Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Letizia
authors.initials: L
authors.lastname: Schreiber
authors.affiliation: a Department of Obstetrics & Gynecology and.
authors.forename: Jacob
authors.initials: J
authors.lastname: Bar
authors.affiliation: a Department of Obstetrics & Gynecology and.
authors.forename: Michal
authors.initials: M
authors.lastname: Kovo
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods*; D004630:Emergencies; D005260:Female; D005316:Fetal Distress / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000502:physiology*; D016015:Logistic Models; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013997:Time Factors
keywords: Active labor; emergent cesarean deliveries; neonatal outcome; non-reassuring fetal heart rate; placental pathology