Abstract
Introduction. A historic cohort study was conducted to evaluate satisfaction with childbirth of a macrosomic baby according to mode of delivery. Material and methods. All 559 nulliparous women who delivered a neonate weighing >4000 g between 2008 and 2012 were included. The degree of women's satisfaction with childbirth after elective cesarean, vaginal delivery or cesarean during labor was assessed using a five-level scale. Immediate neonatal and maternal outcomes were retrieved from clinical records. Long-term maternal outcomes were evaluated using four questionnaires on urinary incontinence, anal incontinence, and sexual functioning. Results. Ninety-nine women underwent elective cesarean, whereas 460 attempted a vaginal delivery. In the latter group, 276 women delivered vaginally, whereas 184 underwent a cesarean during labor. Long-term outcomes were assessed in 273 women (49%; elective cesarean, n = 55; vaginal delivery, n = 135; cesarean in labor, n = 83) after a mean 3-year follow up. The proportion of long-term stress or mixed urinary incontinence was, respectively, 8%, 34%, and 12%, whereas that of anal incontinence was 7%, 19%, and 6%. Sexual functioning was similar in the three groups. No major neonatal complications were observed. When pooling the vaginal delivery and the cesarean in labor groups, the likelihood of being satisfied with childbirth was 63% in the "attempted vaginal delivery" group and 85% in the elective cesarean group (adjusted risk ratio, 0.72; 95% CI 0.61-0.84). Conclusions. About one-third of women attempting a vaginal delivery of a macrosomic baby, would choose an elective cesarean if they could turn back time.
| Original language | English |
|---|---|
| Pages (from-to) | 1235-1244 |
| Number of pages | 10 |
| Journal | Acta Obstetricia et Gynecologica Scandinavica |
| Volume | 94 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - Nov 1 2015 |
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Keywords
- birth injuries
- elective cesarean section
- Fetal macrosomia
- patient satisfaction
- urinary incontinence
ASJC Scopus subject areas
- Obstetrics and Gynaecology
- Medicine(all)
Cite this
Historic cohort study on mode of delivery of a macrosomic baby : The women's point of view. / Vercellini, Paolo; Fumagalli, Monica; Consonni, Dario; De Braud, Lucrezia; Barbara, Giussy; Iurlaro, Enrico; Mosca, Fabio; Fedele, Luigi.
In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 94, No. 11, 01.11.2015, p. 1235-1244.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Historic cohort study on mode of delivery of a macrosomic baby
T2 - The women's point of view
AU - Vercellini, Paolo
AU - Fumagalli, Monica
AU - Consonni, Dario
AU - De Braud, Lucrezia
AU - Barbara, Giussy
AU - Iurlaro, Enrico
AU - Mosca, Fabio
AU - Fedele, Luigi
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Introduction. A historic cohort study was conducted to evaluate satisfaction with childbirth of a macrosomic baby according to mode of delivery. Material and methods. All 559 nulliparous women who delivered a neonate weighing >4000 g between 2008 and 2012 were included. The degree of women's satisfaction with childbirth after elective cesarean, vaginal delivery or cesarean during labor was assessed using a five-level scale. Immediate neonatal and maternal outcomes were retrieved from clinical records. Long-term maternal outcomes were evaluated using four questionnaires on urinary incontinence, anal incontinence, and sexual functioning. Results. Ninety-nine women underwent elective cesarean, whereas 460 attempted a vaginal delivery. In the latter group, 276 women delivered vaginally, whereas 184 underwent a cesarean during labor. Long-term outcomes were assessed in 273 women (49%; elective cesarean, n = 55; vaginal delivery, n = 135; cesarean in labor, n = 83) after a mean 3-year follow up. The proportion of long-term stress or mixed urinary incontinence was, respectively, 8%, 34%, and 12%, whereas that of anal incontinence was 7%, 19%, and 6%. Sexual functioning was similar in the three groups. No major neonatal complications were observed. When pooling the vaginal delivery and the cesarean in labor groups, the likelihood of being satisfied with childbirth was 63% in the "attempted vaginal delivery" group and 85% in the elective cesarean group (adjusted risk ratio, 0.72; 95% CI 0.61-0.84). Conclusions. About one-third of women attempting a vaginal delivery of a macrosomic baby, would choose an elective cesarean if they could turn back time.
AB - Introduction. A historic cohort study was conducted to evaluate satisfaction with childbirth of a macrosomic baby according to mode of delivery. Material and methods. All 559 nulliparous women who delivered a neonate weighing >4000 g between 2008 and 2012 were included. The degree of women's satisfaction with childbirth after elective cesarean, vaginal delivery or cesarean during labor was assessed using a five-level scale. Immediate neonatal and maternal outcomes were retrieved from clinical records. Long-term maternal outcomes were evaluated using four questionnaires on urinary incontinence, anal incontinence, and sexual functioning. Results. Ninety-nine women underwent elective cesarean, whereas 460 attempted a vaginal delivery. In the latter group, 276 women delivered vaginally, whereas 184 underwent a cesarean during labor. Long-term outcomes were assessed in 273 women (49%; elective cesarean, n = 55; vaginal delivery, n = 135; cesarean in labor, n = 83) after a mean 3-year follow up. The proportion of long-term stress or mixed urinary incontinence was, respectively, 8%, 34%, and 12%, whereas that of anal incontinence was 7%, 19%, and 6%. Sexual functioning was similar in the three groups. No major neonatal complications were observed. When pooling the vaginal delivery and the cesarean in labor groups, the likelihood of being satisfied with childbirth was 63% in the "attempted vaginal delivery" group and 85% in the elective cesarean group (adjusted risk ratio, 0.72; 95% CI 0.61-0.84). Conclusions. About one-third of women attempting a vaginal delivery of a macrosomic baby, would choose an elective cesarean if they could turn back time.
KW - birth injuries
KW - elective cesarean section
KW - Fetal macrosomia
KW - patient satisfaction
KW - urinary incontinence
UR - http://www.scopus.com/inward/record.url?scp=84943583069&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84943583069&partnerID=8YFLogxK
U2 - 10.1111/aogs.12723
DO - 10.1111/aogs.12723
M3 - Article
C2 - 26248808
AN - SCOPUS:84943583069
VL - 94
SP - 1235
EP - 1244
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
SN - 0001-6349
IS - 11
ER -