Catastrophic neonatal outcome ups unscheduled C-section rates
Ohad Dan, from the Hebrew University of Jerusalem, and colleagues conducted a retrospective chart review study for all cases of hypoxic-ischemic encephalopathy in singleton, term, liveborn neonates. Seven cases were identified, three of which were due to obstetric mismanagement.
The researchers found that before a mismanaged delivery resulting in hypoxic-ischemic encephalopathy, the baseline rate of unscheduled cesarean deliveries was about 80 per 1,000 deliveries. There was a significant increase in the rate of unscheduled cesarean deliveries in the first four weeks after each of the three identified cases, with an additional 48 unscheduled cesarean deliveries per 1,000 deliveries. This increase was transient, lasting about four weeks. Each case was estimated to be associated with 17 additional unscheduled cesarean deliveries. For cases of hypoxic-ischemic encephalopathy that were not associated with mismanagement, there was no increase in the rate of unscheduled cesarean deliveries.
"The increase in the rate of unscheduled cesarean deliveries after a catastrophic neonatal outcome may result in short-term changes in obstetricians' risk evaluation," the authors write.
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