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Entries in Caesarean Section (5)

Thursday
Feb092012

Premature C-Sections Raise Risk of Infant Breathing Problems

Goodshoot/Thinkstock(NEW YORK) -- Some preterm babies may experience more breathing problems if delivered by Cesarean section instead of vaginally, according to new research presented Thursday at the 32nd annual Society for Maternal-Fetal Medicine Meeting.

C-sections have been thought to benefit premature babies and lessen their risk of complications.

But researchers at Johns Hopkins and Yale University who reviewed 2,560 births in New York City from 1995 to 2003 found that underweight premature infants had a 30-percent greater chance of developing breathing problems when delivered by C-section compared to those delivered vaginally.

Dr. Diane Ashton, deputy medical director of the March of Dimes, said the results “overturn conventional wisdom that C-sections have few or no risks for the baby.”

One in 8 babies is born prematurely in the United States, according to the March of Dimes.

The findings were limited to a small subgroup of babies who grow in the fetus weighing less than 90 percent of babies at the same gestational age -- a condition called intrauterine growth restriction.

The seemingly rare condition can develop if an expectant mother has severe hypertension or kidney disease, or if a baby is malnourished, according to Dr. Lucky Jain, neonatologist and medical director of the Emory Children’s Center at Emory University.

In the study, the babies were delivered before 34 weeks of pregnancy.

Pre-term babies may be at higher risk for stillbirth during vaginal delivery, so they are more often delivered by C-section.

While the findings may give physicians pause to consider an alternate delivery method, Jain said the findings are not likely to change practices for most.

“The study tells me that it may not be a bad idea to let the mother give birth vaginally,” said Jain, adding that, oftentimes, the decision is made based on an individual mother’s situation.

“To change practice, one would have to do a randomized trial, which would be hard to do given the small numbers,” said Jain.

Copyright 2012 ABC News Radio

Monday
Jan092012

Beyonce Says Birth Was ‘Natural,’ Despite Caesarian Reports

Jemal Countess/Getty Images(NEW YORK) -- Royal pop/rap couple Beyonce and Jay-Z issued a statement Monday that she had given birth “naturally” to daughter Blue Ivy on Jan. 7. But initial reports from TMZ prompted Internet buzz over questions about whether a Caesarian birth had been planned.

Some asked: “Is natural childbirth extinct?” with C-sections at an all-time high in the United States.

Today, one in every three babies in the U.S. is born by Caesarean section -- about 32.3 percent, according to the U.S. Centers for Disease Control and Prevention’s Center for Health Statistics. The rate rose by 53 percent between 1996 and 2007 alone.

“Hello Hello Baby Blue,” said the official statement from the couple late Monday. “We are happy to announce the arrival of our beautiful daughter, Blue Ivy Carter … Her birth was emotional and extremely peaceful, we are in heaven. She was delivered naturally at a healthy 7 lbs and it was the best experience of both of our lives."

Early speculation began because more women -- not just those who are at high risk -- are choosing to schedule a Caesarian rather than waiting for labor to begin. It is often called the “Posh push,” so named for Victoria “Posh Spice” Beckham, who with her husband soccer legend David Beckham, had four children by planned C-section.

Women say a C-section is more convenient, less painful and prevents vaginal stretching. Some also opt for a tummy tuck after surgery.

The medical term for this is “delivery on maternal request,” according to Dr. Vincenzo Berghella, director of maternal fetal medicine at Thomas Jefferson Hospital in Philadelphia. “It’s not a new phenomenon -- it’s been going on for years.”

Only about 10 percent of American women choose to have a Caesarian this way, and the rate is far higher in countries like Italy and Brazil, where the C-section rate is almost 90 percent of all births,  according to Berghella.

“Women don’t want to mess their bodies up,” he said.

“Like anything else, it has possible consequences and risks,” said Berghella. “If you were a 40-year-old or older woman having just one baby, having one C-section and not planning any more babies is not that unreasonable because the problem with doing a C-section just for the sake of doing it, you have a lot more risk to both the mother and baby.”

It’s not only expectant mothers, but doctors who favor Caesarians. In a study published in 2011 in the Journal of Obstetrics and Gynecology, 29 percent of doctors polled said they were performing more C-sections because they feared lawsuits. Traditional births can lead to more complications than a C-section procedure.

But the trend has alarmed some medical professionals who say C-sections are more likely to cause problems that put the mother in the hospital -- and the baby in intensive care.

A condition called placenta accreta, which can kill both mother and baby, is on the rise in the U.S., largely because of the increase in C-sections.

Once a rare event that affected 1 in 30,000 pregnant women in the 1950s and 1960s, placenta accreta now affects 1 in 2,500 pregnancies, according to a 2007 report in the Journal of Obstetrics and Gynecology. In some hospitals, the number is as high as 1 in 522.

A Caesarian, or any kind of surgery, including an abortion or a D & C, can destroy that layer, allowing the placenta to invade the body cavity.

“There is a chance of needing a transfusion and even losing the uterus to bleeding and much more a chance of infection and even dying of it,” said Berghella.

Copyright 2012 ABC News Radio

Tuesday
Nov082011

Mich. Hospitals Leading the Way in Alternatives to C-Section Births

Keith Brofsky/Thinkstock(DEARBORN, Mich.) -- An obstetrics project developed by the Michigan Health and Hospital Association Keystone is being identified by health officials as a major initiative towards eliminating unnecessary Caesarean births and improving the health of newborns, according to a report in the Detroit Free Press.

Lead researchers of the project say some of the findings have already resulted in major changes at 65 Michigan hospitals as officials develop healthy alternatives to C-section and drug-inducing births. The project focuses on discouraging C-section births if the mother suffers from a chronic disease or is carrying more than one baby, according to the report.

"We've had a better outcome," Dr. Charles Cash, Oakwood Hospital's obstetrics director, told the Free Press. "We've improved the safety and the quality of the community."

Among the other findings during the course of the research has been a decrease in the amount of special care required for infants following birth.

Copyright 2011 ABC News Radio

Friday
Oct212011

Women Avoid Giving Birth on Halloween, Study Finds

Creatas Images/Thinkstock(NEW HAVEN, Conn.) -- Halloween is a day for painted faces, ghoulish frights and candy-induced sugar comas, but not much of a day for having babies, according to new research from Yale's School of Public Health.

Researchers hypothesized that women may hold off or speed up when they go into labor in order to avoid giving birth on holidays with negative connotations, such as Halloween, and aim for giving birth on "positive" holidays, such as Valentine's Day.  When they tracked the number of births occurring in the week before and after these holidays between 1996 and 2006, they found that the number of spontaneous births and Caesarean births rose and dipped according to this hypothesis.

Using a sample of all the births occurring in the U.S. during those years, researchers calculated the trends in spontaneous births, induced births and Caesarean.  There was a 3.6 percent increase in spontaneous births and a 12.1 percent increase in Caesarean births on Valentine's Day and a 5.3 percent decrease in spontaneous births and a 16.9 percent decrease in Caesarean births on Halloween.

"This study raises the possibility that the assumption underlying the term 'spontaneous births,' namely, that they are outside the control of pregnant women, is erroneous.  For it appears that pregnant women can expedite or delay spontaneous births, within a limited time frame, in response to cultural representations," the authors wrote.

Copyright 2011 ABC News Radio

Tuesday
Mar222011

Texas Proposal Looks to Curb Elective Deliveries Before 39 Weeks

Photodisc/Thinkstock(AUSTIN, Texas) -- Texas health officials estimate they could save $36.5 million in Medicaid costs by curbing convenient, but risky, baby deliveries before the 39th week of pregnancy, while reining in use of expensive neonatal intensive care units.

For a variety of reasons -- some as mundane as moms-to-be wanting to guarantee that their obstetricians won't be on vacation when they go into labor, or that Grandma will be able to plan her trip to help out in the nursery -- some obstetricians agree to early deliveries, either by Caesarean section or induced labor.

However, early elective childbirth can subject newborns to many of the stresses of prematurity, which studies have shown can include blindness, underdeveloped lungs and long-term emotional, intellectual, developmental and behavioral issues.

These can include attention deficit disorder, said Dr. Frank Mazza, chief patient safety officer for the Austin-based Seton Family of Hospitals.

A half dozen Seton hospitals helped pioneer a highly successful program that drastically reduced NICU use by following American Congress of Obstetricians and Gynecologists guidance to stop performing elective deliveries before 39 weeks.  The program had no effect on medically necessary early deliveries.

By strictly adhering to that cutoff, Seton hospitals reduced NICU costs associated with prematurity and traumatic delivery from $4.5 million a year to "somewhere in the neighborhood of $186,000 a year," Mazza said in an interview Monday.  The hospitals have consistently posted NICU savings for the last seven years, he added.

That test program, which also led to more healthy births, provided much of the impetus for the cost-saving proposal put forth last month by the Texas Health and Human Services Commission.  That measure seeks to reduce early elective deliveries and more closely scrutinize which babies are admitted to NICUs.

"We just really want to put an extra check and balance in place, and have doctors or hospitals call in and verify why that baby needs NICU treatment before they put them in," said Stephanie Goodman, a spokeswoman for HHSC in Austin, which administers the Medicaid program in Texas.

"We feel like that extra step may just help make sure that the babies in NICUs really need that level of care, and that any other baby that could be better-served or as well-served in just the regular nursery, would."

While it's unclear how many cash-strapped states might follow suit and try to find similar savings in the delivery room and NICUs, any such actions could cut deeply into hospital revenues. 

Copyright 2011 ABC News Radio







ABC News Radio