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Multicenter Study
. 2010 Oct;203(4):326.e1-326.e10.
doi: 10.1016/j.ajog.2010.06.058. Epub 2010 Aug 12.

Contemporary cesarean delivery practice in the United States

Jun Zhang  1 , James Troendle, Uma M Reddy, S Katherine Laughon, D Ware Branch, Ronald Burkman, Helain J Landy, Judith U Hibbard, Shoshana Haberman, Mildred M Ramirez, Jennifer L Bailit, Matthew K Hoffman, Kimberly D Gregory, Victor H Gonzalez-Quintero, Michelle Kominiarek, Lee A Learman, Christos G Hatjis, Paul van Veldhuisen; Consortium on Safe Labor
Affiliations
Multicenter Study

Contemporary cesarean delivery practice in the United States

Jun Zhang et al. Am J Obstet Gynecol. 2010 Oct.

Abstract

Objective: To describe contemporary cesarean delivery practice in the United States.

Study design: Consortium on Safe Labor collected detailed labor and delivery information from 228,668 electronic medical records from 19 hospitals across the United States, 2002-2008.

Results: The overall cesarean delivery rate was 30.5%. The 31.2% of nulliparous women were delivered by cesarean section. Prelabor repeat cesarean delivery due to a previous uterine scar contributed 30.9% of all cesarean sections. The 28.8% of women with a uterine scar had a trial of labor and the success rate was 57.1%. The 43.8% women attempting vaginal delivery had induction. Half of cesarean for dystocia in induced labor were performed before 6 cm of cervical dilation.

Conclusion: To decrease cesarean delivery rate in the United States, reducing primary cesarean delivery is the key. Increasing vaginal birth after previous cesarean rate is urgently needed. Cesarean section for dystocia should be avoided before the active phase is established, particularly in nulliparous women and in induced labor.

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Figures

Figure 1
Figure 1
Cesarean delivery rate by type of cesarean (prelabor vs. intrapartum), gestational age and parity (nulliparas, multiparas, women with a uterine scar).
Figure 2
Figure 2
Cervical dilation at intrapartum cesarean delivery among women attempting vaginal delivery by parity, onset of labor (induced vs. spontaneous onset), previous uterine scar in singleton gestations
See this image and copyright information in PMC

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