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Artigos Originais
Risk factors for the indication of caesarean section in Campinas (SP)
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):34-40
04-04-2007
Summary
Artigos OriginaisRisk factors for the indication of caesarean section in Campinas (SP)
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):34-40
04-04-2007DOI 10.1590/S0100-72032007000100006
Views70PURPOSE: to determine the cesarean section (CS) rate in Campinas (SP) and to identify its risk factors. METHODS: a cross-sectional study that analyzed data obtained from Live Birth Certificates in 2001. The dependent variable was the type of delivery and the independent variables were: mothers’ characteristics and those related to their pregnancies, deliveries and to newborns. The assessment of the association among variables was performed through the chi2 test, and crude and adjusted odds ratio (OR) values were calculated. RESULTS: the CS rate was 54.9%. The chances of having CS increased 1.9 times for women from 20-34 years old (adjOR-1.9; 95% CI:1.7-2.1); 3.7 times for those over 35 years old (adjOR-3.8; 95% CI:3.2-4.5); 1.5 times for those who studied from 8-11 years (adjOR-1.5; 95% CI:1.4-1.6); 2.5 times for those who studied more than 11 years (adjOR-2.6; 95% CI:2.2-2.9); 1.3 times for those who were married (adjOR-1.3; 95 % CI:1.2-1.4); 1.6 times for those who had jobs (adjOR-1.6; 95% CI:1.5-1.8); 1.2 times for who had good living conditions (adjOR-1.2; 95% CI:1.0-1.3); 2.2 times for primiparous (adjOR-2.2; 95% CI:1.9-2.5), 1.6 times for multiparous (adjOR-1.6; 95% CI:1.4-1.9) and 2.7 times in twin gestations (adjOR-2.7; 95% CI:1.9-3.9). The women who had inadequate prenatal care were protected for CS (adjOR-0.6; 95% CI:0.5-0.7). CONCLUSION: the chance of having CS was greater among women with better socio-economic conditions, with adequate prenatal care, for primiparous, for multiparous and in twin gestations, suggesting that the basis for indication of cesarean sections were not restricted to clinical factors but influenced by non-medical reasons.
Key-words Cesarean sectionEpidemiologyRisk factorsSexual and reproductive healthSocioeconomic factorsSee morePlumX Metrics
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Views70PlumX Metrics- Citations
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisRisk factors for the indication of caesarean section in Campinas (SP)
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(1):34-40
04-04-2007DOI 10.1590/S0100-72032007000100006
Views70PURPOSE: to determine the cesarean section (CS) rate in Campinas (SP) and to identify its risk factors. METHODS: a cross-sectional study that analyzed data obtained from Live Birth Certificates in 2001. The dependent variable was the type of delivery and the independent variables were: mothers’ characteristics and those related to their pregnancies, deliveries and to newborns. The assessment of the association among variables was performed through the chi2 test, and crude and adjusted odds ratio (OR) values were calculated. RESULTS: the CS rate was 54.9%. The chances of having CS increased 1.9 times for women from 20-34 years old (adjOR-1.9; 95% CI:1.7-2.1); 3.7 times for those over 35 years old (adjOR-3.8; 95% CI:3.2-4.5); 1.5 times for those who studied from 8-11 years (adjOR-1.5; 95% CI:1.4-1.6); 2.5 times for those who studied more than 11 years (adjOR-2.6; 95% CI:2.2-2.9); 1.3 times for those who were married (adjOR-1.3; 95 % CI:1.2-1.4); 1.6 times for those who had jobs (adjOR-1.6; 95% CI:1.5-1.8); 1.2 times for who had good living conditions (adjOR-1.2; 95% CI:1.0-1.3); 2.2 times for primiparous (adjOR-2.2; 95% CI:1.9-2.5), 1.6 times for multiparous (adjOR-1.6; 95% CI:1.4-1.9) and 2.7 times in twin gestations (adjOR-2.7; 95% CI:1.9-3.9). The women who had inadequate prenatal care were protected for CS (adjOR-0.6; 95% CI:0.5-0.7). CONCLUSION: the chance of having CS was greater among women with better socio-economic conditions, with adequate prenatal care, for primiparous, for multiparous and in twin gestations, suggesting that the basis for indication of cesarean sections were not restricted to clinical factors but influenced by non-medical reasons.
Key-words Cesarean sectionEpidemiologyRisk factorsSexual and reproductive healthSocioeconomic factorsSee morePlumX Metrics- Citations
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Trabalhos Originais
Necrotizing Fasciitis in Obstetric Patients
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):557-561
04-04-1998
Summary
Trabalhos OriginaisNecrotizing Fasciitis in Obstetric Patients
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):557-561
04-04-1998DOI 10.1590/S0100-72031998001000003
Views86See morePurpose: the authors report their experience with necrotizing fasciitis (NF) cases which occurred in the Gynecology and Obstetrics Service of the Hospital de Clínicas de Porto Alegre, assessing the frequency of NF and analyzing the association between NF and certain risk factors cited in the literature. Methods: a retrospective study of patients a with diagnosis of necrotizing fasciitis at the Hospital de Clínicas de Porto Alegre from January 1990 to December 1997. Results: two post-cesarean section and one post-surgical (because of ectopic pregnancy) NF cases were found. None of the patients presented clinical complications nor NF risk factors and all surgeries were urgent. The NF frequency in this study was 2.6/10.000 cesarians and mortality was zero. Discussion: NF is a clinical syndrome which does not occur very often but is associated with high morbidity and mortality. This disease involves the surgical wound and the fascial plans. Fast handling and early and intensive treatment bring about good results and decrease in the mortality rate.
Views86This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisNecrotizing Fasciitis in Obstetric Patients
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):557-561
04-04-1998DOI 10.1590/S0100-72031998001000003
Views86See morePurpose: the authors report their experience with necrotizing fasciitis (NF) cases which occurred in the Gynecology and Obstetrics Service of the Hospital de Clínicas de Porto Alegre, assessing the frequency of NF and analyzing the association between NF and certain risk factors cited in the literature. Methods: a retrospective study of patients a with diagnosis of necrotizing fasciitis at the Hospital de Clínicas de Porto Alegre from January 1990 to December 1997. Results: two post-cesarean section and one post-surgical (because of ectopic pregnancy) NF cases were found. None of the patients presented clinical complications nor NF risk factors and all surgeries were urgent. The NF frequency in this study was 2.6/10.000 cesarians and mortality was zero. Discussion: NF is a clinical syndrome which does not occur very often but is associated with high morbidity and mortality. This disease involves the surgical wound and the fascial plans. Fast handling and early and intensive treatment bring about good results and decrease in the mortality rate.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Trabalhos Originais
Delivery and Medical Attendance Types in Uberaba-MG
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(2):99-104
03-20-1999
Summary
Trabalhos OriginaisDelivery and Medical Attendance Types in Uberaba-MG
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(2):99-104
03-20-1999DOI 10.1590/S0100-72031999000200007
Views54See morePurpose: to study the actual conditions of medical assistance and types of delivery and factors contributing to their indication in Uberaba, MG. Method: the data of 4,294 puerperas who gave birth in the period from April 15, 1992 to April 14, 1993 in 7 maternities in Uberaba were studied. Results: it was seen that the Teaching Hospital had a greater participation in deliveries attending the younger population, probably the poorest and most unprepared regarding pregnancy. It was the only Hospital in which cesarean section rates were near those accepted by the who. Medical assistance in Uberaba was predominantly through Social Security (SUS), private health insurance and physicians representing a lower proportion. It was also verified that cesarean section frequency increased with age and type of medical assistance and the groups with private coverage presented a higher number of cesarean sections. Conclusion: it may be perhaps justified to consider the social factor as interfering with the indication of type of delivery.
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Views54PlumX Metrics- Citations
- Citation Indexes: 2
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- Full Text Views: 17962
- Abstract Views: 582
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- Readers: 13
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisDelivery and Medical Attendance Types in Uberaba-MG
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(2):99-104
03-20-1999DOI 10.1590/S0100-72031999000200007
Views54See morePurpose: to study the actual conditions of medical assistance and types of delivery and factors contributing to their indication in Uberaba, MG. Method: the data of 4,294 puerperas who gave birth in the period from April 15, 1992 to April 14, 1993 in 7 maternities in Uberaba were studied. Results: it was seen that the Teaching Hospital had a greater participation in deliveries attending the younger population, probably the poorest and most unprepared regarding pregnancy. It was the only Hospital in which cesarean section rates were near those accepted by the who. Medical assistance in Uberaba was predominantly through Social Security (SUS), private health insurance and physicians representing a lower proportion. It was also verified that cesarean section frequency increased with age and type of medical assistance and the groups with private coverage presented a higher number of cesarean sections. Conclusion: it may be perhaps justified to consider the social factor as interfering with the indication of type of delivery.
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Trabalhos Originais
Postmortem cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(6):341-345
08-02-1999
Summary
Trabalhos OriginaisPostmortem cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(6):341-345
08-02-1999DOI 10.1590/S0100-72031999000600007
Views74See moreObjectives: to analyze the medical and legal aspects in order to contribute to the study and standardization of this obstetrical surgery in Brazil. Methods: our study was based on 11 cases of cesarean section performed in the imminence of maternal death or just after death. These cases were attended at UNIFESP - EPM from 1988 to 1998. Results: there were 7 live births, five of them with a gestational age over 26 weeks. Most deaths occurred within the first 48 hours after admission. The predominant age range was the third decade. Conclusions: although postmortem cesarean section is indicated to save the fetus, it is rarely performed. The conditions for its indication involve knowledge of the technique as well as of the ethical and legal principles.
Views74This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisPostmortem cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(6):341-345
08-02-1999DOI 10.1590/S0100-72031999000600007
Views74See moreObjectives: to analyze the medical and legal aspects in order to contribute to the study and standardization of this obstetrical surgery in Brazil. Methods: our study was based on 11 cases of cesarean section performed in the imminence of maternal death or just after death. These cases were attended at UNIFESP - EPM from 1988 to 1998. Results: there were 7 live births, five of them with a gestational age over 26 weeks. Most deaths occurred within the first 48 hours after admission. The predominant age range was the third decade. Conclusions: although postmortem cesarean section is indicated to save the fetus, it is rarely performed. The conditions for its indication involve knowledge of the technique as well as of the ethical and legal principles.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Revisão
Strategies to avoid vertical transmission of human immunodeficiency virus type 1
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):768-778
04-13-2005
Summary
RevisãoStrategies to avoid vertical transmission of human immunodeficiency virus type 1
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):768-778
04-13-2005DOI 10.1590/S0100-72032005001200010
Views60See moreKnowledge about the factors or situations that influence the vertical transmission (VT) of human immunodeficiency type 1 (HIV-1) has led to the implementation of strategies which have promoted a rate decline along the years, from 40% to less than 3% nowadays. One of the major advances in the area has been the prophylactic administration of zidovudine (AZT), in the prenatal phase (oral route), in the predelivery phase (intravenous route) and to the newborn (oral route). This intervention may reduce HIV-1 VT 68%, thus being the most effective isolated strategy used so far. In the chronological sequence of advances, it has been observed that a high viral load is the main risk indicator for this type of transmission. As AZT does not reduce the viral load and does not control the residual rate observed in HIV-1 VT, the use of prophylactic schemes using three antiretroviral drugs has been encouraged. Elective caesarean section completes the range of obstetric strategies with major impact on the reduction of HIV-1 VT. Its effectiveness is linked to the observation of the criteria for its indication: viral load assessed after the 34th week of pregnancy with levels over 1000 copies/mL, gestation over 38 weeks confirmed by ultrasonography, intact chorioamniotic membranes, and performed before labor has started. In cases where normal delivery is indicated, it should be remembered that prolonged chorioamniorrhexis, invasive manipulation of the fetus, delivery with instruments and episiotomy are situations to be avoided. Among the postnatal interventions considered important for the reduction of HIV-1 VT are: pediatric reception (this should be done by trained professionals, avoiding microtraumas in the mucosa during the sucking maneuvers, use of neonatal AZT (for a period of six weeks) and bottle feeding. Special attention should be given to the orientation for the mother, in order to prevent acute infection by HIV-1 in this period, what would markedly increase virus VT rate.
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Views60PlumX Metrics- Citations
- Citation Indexes: 3
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- Full Text Views: 16582
- Abstract Views: 697
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- Readers: 16
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
RevisãoStrategies to avoid vertical transmission of human immunodeficiency virus type 1
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(12):768-778
04-13-2005DOI 10.1590/S0100-72032005001200010
Views60See moreKnowledge about the factors or situations that influence the vertical transmission (VT) of human immunodeficiency type 1 (HIV-1) has led to the implementation of strategies which have promoted a rate decline along the years, from 40% to less than 3% nowadays. One of the major advances in the area has been the prophylactic administration of zidovudine (AZT), in the prenatal phase (oral route), in the predelivery phase (intravenous route) and to the newborn (oral route). This intervention may reduce HIV-1 VT 68%, thus being the most effective isolated strategy used so far. In the chronological sequence of advances, it has been observed that a high viral load is the main risk indicator for this type of transmission. As AZT does not reduce the viral load and does not control the residual rate observed in HIV-1 VT, the use of prophylactic schemes using three antiretroviral drugs has been encouraged. Elective caesarean section completes the range of obstetric strategies with major impact on the reduction of HIV-1 VT. Its effectiveness is linked to the observation of the criteria for its indication: viral load assessed after the 34th week of pregnancy with levels over 1000 copies/mL, gestation over 38 weeks confirmed by ultrasonography, intact chorioamniotic membranes, and performed before labor has started. In cases where normal delivery is indicated, it should be remembered that prolonged chorioamniorrhexis, invasive manipulation of the fetus, delivery with instruments and episiotomy are situations to be avoided. Among the postnatal interventions considered important for the reduction of HIV-1 VT are: pediatric reception (this should be done by trained professionals, avoiding microtraumas in the mucosa during the sucking maneuvers, use of neonatal AZT (for a period of six weeks) and bottle feeding. Special attention should be given to the orientation for the mother, in order to prevent acute infection by HIV-1 in this period, what would markedly increase virus VT rate.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Artigos Originais
The influence of the delivery route on pelvic floor muscle strength
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(11):677-682
04-10-2005
Summary
Artigos OriginaisThe influence of the delivery route on pelvic floor muscle strength
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(11):677-682
04-10-2005DOI 10.1590/S0100-72032005001100008
Views36See morePURPOSE: to evaluate the influence of the delivery route on pelvic floor (PF) muscle strength. METHODS: a cross-sectional study was conducted to evaluate PF muscle strength by the pelvic floor strength evaluation (PFSE) test and perineometer in primiparous patients aged 20 to 30 years 4 to 6 months after delivery. The categorization was: zero lack of muscle contraction; one - weak contraction; two - moderate contraction not sustained for 6 s and three - normal contraction sustained for 6 s. A total of 94 patients were divided into there groups based on prior delivery route. They were: 32 patients with vaginal delivery with singleton cephalic presentation; 32 patients with cesarean delivery, and 30 nulliparous patients as a control group. The independent variable was delivery route and the dependent one was the muscle strength of the PF. Comparison between contraction levels was performed by Kruskal-Wallis and Dunn multiple comparison tests and the influence of delivery method was tested by chi2. Confidence interval of 95% was obtained for relative risk (RR) of Pf muscle strength changes and kappa statistics. RESULTS: the 1st and 3rd quartiles of delivery route regarding PF muscle strength were lower (p=0.01) for vaginal delivery (2.0;1-2) and intermediate for cesarean section (2.0;2-3) compared to the nulliparous (3.0;2-3) by the PFSE test and perineometer. RR of the altered examination was increased after vaginal delivery (RR=2.58; CI 95%: 1.32-5.04, p=0.002); (RR=2.31; CI 95%: 1.24-4.32, p=0.005), and after cesarean section (RR=1.56; CI 95%: 0.94-2.57, p= 0.12); (RR=1.38; CI 95%: 0.85-2.23, p=0.29) by AFA and perineometer, respectively. CONCLUSIONS: vaginal delivery decreased PF muscle strength when compared with cesarean delivery and control groups.
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Views36PlumX Metrics- Citations
- Citation Indexes: 6
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisThe influence of the delivery route on pelvic floor muscle strength
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(11):677-682
04-10-2005DOI 10.1590/S0100-72032005001100008
Views36See morePURPOSE: to evaluate the influence of the delivery route on pelvic floor (PF) muscle strength. METHODS: a cross-sectional study was conducted to evaluate PF muscle strength by the pelvic floor strength evaluation (PFSE) test and perineometer in primiparous patients aged 20 to 30 years 4 to 6 months after delivery. The categorization was: zero lack of muscle contraction; one - weak contraction; two - moderate contraction not sustained for 6 s and three - normal contraction sustained for 6 s. A total of 94 patients were divided into there groups based on prior delivery route. They were: 32 patients with vaginal delivery with singleton cephalic presentation; 32 patients with cesarean delivery, and 30 nulliparous patients as a control group. The independent variable was delivery route and the dependent one was the muscle strength of the PF. Comparison between contraction levels was performed by Kruskal-Wallis and Dunn multiple comparison tests and the influence of delivery method was tested by chi2. Confidence interval of 95% was obtained for relative risk (RR) of Pf muscle strength changes and kappa statistics. RESULTS: the 1st and 3rd quartiles of delivery route regarding PF muscle strength were lower (p=0.01) for vaginal delivery (2.0;1-2) and intermediate for cesarean section (2.0;2-3) compared to the nulliparous (3.0;2-3) by the PFSE test and perineometer. RR of the altered examination was increased after vaginal delivery (RR=2.58; CI 95%: 1.32-5.04, p=0.002); (RR=2.31; CI 95%: 1.24-4.32, p=0.005), and after cesarean section (RR=1.56; CI 95%: 0.94-2.57, p= 0.12); (RR=1.38; CI 95%: 0.85-2.23, p=0.29) by AFA and perineometer, respectively. CONCLUSIONS: vaginal delivery decreased PF muscle strength when compared with cesarean delivery and control groups.
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Trabalhos Originais
Factors Associated with Cesarean Section in Primipara Women with One Previous Cesarean Section
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(3):175-179
10-18-2000
Summary
Trabalhos OriginaisFactors Associated with Cesarean Section in Primipara Women with One Previous Cesarean Section
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(3):175-179
10-18-2000DOI 10.1590/S0100-72032000000300009
Views110See morePurpose: to evaluate the route of delivery in a group of low-income primipara pregnant women with a previous cesarean section, and the factors associated with the repetition of the cesarean section on the second delivery. Patients and Methods: it was a case-control study including 356 women who were assisted at the Maternity of CAISM/UNICAMP during the period between January 1993 and January 1996. The cases were 153 women whose second delivery was through a cesarean section and the controls were 203 women whose second delivery was vaginal. For analysis, means, standard deviation, Student's t-test, Mann-Whitney test, chi² test and odds ratio (OR) with 95% CI for each factor possibly associated with cesarean section on the second delivery were used. Results: the route of the second delivery was vaginal for 57% of the women. Among the several variables studied, those which showed to be significantly associated with a cesarean section on the second delivery were: higher maternal age (for women over 35 years, OR = 16.4), previous abortions (OR = 2.09), induced labor (OR = 3,83), premature rupture of membranes (OR = 2.83), not having an epidural analgesia performed during labor (OR = 5.3), the finding of some alteration in fetal well-being (OR = 2.7) and the delivery occurring during the afternoon (OR = 1.92). Conclusions: these results indicate that the factors associated with the repetition of cesarean section in women with a previous scar of cesarean section in this population are predominantly medical; however, there is still the possibility of proposing interventions directed to decreasing the rates of repeated cesarean sections.
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Views110PlumX Metrics- Citations
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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Trabalhos OriginaisFactors Associated with Cesarean Section in Primipara Women with One Previous Cesarean Section
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(3):175-179
10-18-2000DOI 10.1590/S0100-72032000000300009
Views110See morePurpose: to evaluate the route of delivery in a group of low-income primipara pregnant women with a previous cesarean section, and the factors associated with the repetition of the cesarean section on the second delivery. Patients and Methods: it was a case-control study including 356 women who were assisted at the Maternity of CAISM/UNICAMP during the period between January 1993 and January 1996. The cases were 153 women whose second delivery was through a cesarean section and the controls were 203 women whose second delivery was vaginal. For analysis, means, standard deviation, Student's t-test, Mann-Whitney test, chi² test and odds ratio (OR) with 95% CI for each factor possibly associated with cesarean section on the second delivery were used. Results: the route of the second delivery was vaginal for 57% of the women. Among the several variables studied, those which showed to be significantly associated with a cesarean section on the second delivery were: higher maternal age (for women over 35 years, OR = 16.4), previous abortions (OR = 2.09), induced labor (OR = 3,83), premature rupture of membranes (OR = 2.83), not having an epidural analgesia performed during labor (OR = 5.3), the finding of some alteration in fetal well-being (OR = 2.7) and the delivery occurring during the afternoon (OR = 1.92). Conclusions: these results indicate that the factors associated with the repetition of cesarean section in women with a previous scar of cesarean section in this population are predominantly medical; however, there is still the possibility of proposing interventions directed to decreasing the rates of repeated cesarean sections.
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Artigos Originais
Analysis of the risk factors for cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):189-196
07-30-2005
Summary
Artigos OriginaisAnalysis of the risk factors for cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):189-196
07-30-2005DOI 10.1590/S0100-72032005000400005
Views74PURPOSE: to create a predictive model for cesarean section at the "Professor Monteiro de Morais Maternity" after evaluation of antepartum risk factors of the pregnant women who delivered from September 1, 1999 to August 31, 2000, and then, to verify the efficacy of indication for cesarean section. METHODS: a longitudinal, case control study with 3.626 pregnant women was performed to identify the antepartum risk factors for cesarean section in the period from September 1, 1999 to August 31, 2000. Thereafter an ideal model able to quantify the risk for cesarean section for each patient in the presence of one or more risk factor was created. Then, the model was applied to the patients of the study in order to verify the efficacy of indication for cesarean section. RESULTS: the baseline risk for cesarean section was 15.2%. The concordance between the percentage estimated through logistic model and cesarean delivery was 86.6%. CONCLUSIONS: the logistic model was able to identify the baseline risk for cesarean section and to quantify the increase in risk for cesarean section in each patient when risk factors were introduced in the model. The model can be considered efficient and able to predict cesarean section because the agreemant between the prediction and the correct indication was 86.6%, and 53.6% of the patients who had vaginal delivery did not have any risk factor for cesarean section.
Key-words Cesarean deliveryCesarean sectionNatural childbirthPredictive modelProblem salvingRisk factorsSee morePlumX Metrics- Citations
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Views74PlumX Metrics- Citations
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- Full Text Views: 13879
- Abstract Views: 1129
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- Readers: 16
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Artigos OriginaisAnalysis of the risk factors for cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):189-196
07-30-2005DOI 10.1590/S0100-72032005000400005
Views74PURPOSE: to create a predictive model for cesarean section at the "Professor Monteiro de Morais Maternity" after evaluation of antepartum risk factors of the pregnant women who delivered from September 1, 1999 to August 31, 2000, and then, to verify the efficacy of indication for cesarean section. METHODS: a longitudinal, case control study with 3.626 pregnant women was performed to identify the antepartum risk factors for cesarean section in the period from September 1, 1999 to August 31, 2000. Thereafter an ideal model able to quantify the risk for cesarean section for each patient in the presence of one or more risk factor was created. Then, the model was applied to the patients of the study in order to verify the efficacy of indication for cesarean section. RESULTS: the baseline risk for cesarean section was 15.2%. The concordance between the percentage estimated through logistic model and cesarean delivery was 86.6%. CONCLUSIONS: the logistic model was able to identify the baseline risk for cesarean section and to quantify the increase in risk for cesarean section in each patient when risk factors were introduced in the model. The model can be considered efficient and able to predict cesarean section because the agreemant between the prediction and the correct indication was 86.6%, and 53.6% of the patients who had vaginal delivery did not have any risk factor for cesarean section.
Key-words Cesarean deliveryCesarean sectionNatural childbirthPredictive modelProblem salvingRisk factorsSee morePlumX Metrics- Citations
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