PMID- 38235842
OWN - NLM
STAT- Publisher
LR  - 20240118
IS  - 1879-3479 (Electronic)
IS  - 0020-7292 (Linking)
DP  - 2024 Jan 18
TI  - Impacted fetal head extraction methods at second stage cesarean and subsequent 
      preterm delivery: A multicenter study.
LID - 10.1002/ijgo.15383 [doi]
AB  - OBJECTIVE: Second-stage cesarean delivery (CD) is associated with subsequent 
      preterm birth (PTB). It has been suggested that an increased risk of PTB after 
      second-stage cesarean delivery could be linked to a higher chance of cervical 
      injury due to the extension of the uterine incision. Previous studies have shown 
      that reverse breech extraction is associated with lower rates of uterine incision 
      extensions compared to the "push" method. We aimed to investigate the association 
      between the method of fetal extraction during second-stage CD and the rate of 
      spontaneous PTB (sPTB), as well as other maternal and neonatal outcomes during 
      the subsequent pregnancy. METHODS: This was a multicenter retrospective cohort 
      study. The study population included women in their first subsequent singleton 
      delivery following a second-stage CD between 2004 and 2021. The main exposure of 
      interest was the method of fetal extraction in the index CD ("push" method vs. 
      reverse breech extraction). The primary outcome of this study was sPTB <37 weeks 
      in the subsequent pregnancy. Secondary outcomes were overall PTB, trial of labor, 
      and other adverse maternal and neonatal outcomes. Univariate analysis was 
      followed by multiple logistic regression modeling. RESULTS: During the study 
      period, 2969 index CD during second stage were performed, of those 583 met the 
      inclusion criteria, of whom 234 (40.1%) had fetal extraction using the reverse 
      breech extraction method, while 349 (59.9%) had the "push" method for extraction. 
      In univariate analysis, women in those two groups had statistically similar rates 
      of sPTB (3.7% vs. 3.0%; odds ratio [OR] 1.25, 95% CI: 0.49-3.19) and overall PTB 
      (<37, <34 and <32 weeks), as well as other maternal, neonatal, and trial of labor 
      outcomes. This was confirmed by multivariate analyses with an adjusted OR of 1.27 
      (95% CI: 0.43-3.71) for sPTB. CONCLUSION: Among women with a previous 
      second-stage CD, no significant difference was observed in PTB rates in the 
      subsequent pregnancies following the "push" method compared to the reverse breech 
      extraction method.
CI  - (c) 2024 The Authors. International Journal of Gynecology & Obstetrics published by 
      John Wiley & Sons Ltd on behalf of International Federation of Gynecology and 
      Obstetrics.
FAU - Peled, Tzuria
AU  - Peled T
AD  - Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated 
      with the Hebrew University School of Medicine, Jerusalem, Israel.
FAU - Muraca, Giulia M
AU  - Muraca GM
AD  - Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, 
      Canada.
AD  - Department of Health Research Methods, Evidence and Impact, Faculty of Health 
      Sciences, McMaster University, Hamilton, Ontario, Canada.
AD  - Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, 
      Stockholm, Sweden.
FAU - Ratner, Miri
AU  - Ratner M
AD  - Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated 
      with the Hebrew University School of Medicine, Jerusalem, Israel.
FAU - Sela, Hen Y
AU  - Sela HY
AD  - Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated 
      with the Hebrew University School of Medicine, Jerusalem, Israel.
FAU - Kirubarajan, Abirami
AU  - Kirubarajan A
AD  - Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, 
      Canada.
FAU - Weiss, Ari
AU  - Weiss A
AD  - Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated 
      with the Hebrew University School of Medicine, Jerusalem, Israel.
FAU - Grisaru-Granovsky, Sorina
AU  - Grisaru-Granovsky S
AD  - Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated 
      with the Hebrew University School of Medicine, Jerusalem, Israel.
FAU - Rottenstreich, Misgav
AU  - Rottenstreich M
AUID- ORCID: 0000-0003-4875-1455
AD  - Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated 
      with the Hebrew University School of Medicine, Jerusalem, Israel.
AD  - Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, 
      Canada.
AD  - Department of Nursing, Jerusalem College of Technology, Jerusalem, Israel.
LA  - eng
PT  - Journal Article
DEP - 20240118
PL  - United States
TA  - Int J Gynaecol Obstet
JT  - International journal of gynaecology and obstetrics: the official organ of the 
      International Federation of Gynaecology and Obstetrics
JID - 0210174
SB  - IM
OTO - NOTNLM
OT  - cesarean delivery
OT  - fetal extraction technique
OT  - impacted fetal head
OT  - preterm birth
OT  - second stage
OT  - subsequent delivery
OT  - technique
EDAT- 2024/01/18 12:43
MHDA- 2024/01/18 12:43
CRDT- 2024/01/18 08:29
PHST- 2023/12/22 00:00 [revised]
PHST- 2023/11/09 00:00 [received]
PHST- 2024/01/02 00:00 [accepted]
PHST- 2024/01/18 12:43 [medline]
PHST- 2024/01/18 12:43 [pubmed]
PHST- 2024/01/18 08:29 [entrez]
AID - 10.1002/ijgo.15383 [doi]
PST - aheadofprint
SO  - Int J Gynaecol Obstet. 2024 Jan 18. doi: 10.1002/ijgo.15383.