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Related Experiment Videos

Cesarean delivery on maternal request.

Meera Viswanathan, Anthony G Visco, Katherine Hartmann

    Evidence Report/Technology Assessment
    |July 14, 2007
    PubMed
    Summary
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    Cesarean delivery on maternal request (CDMR) appears to be increasing, but evidence on its outcomes compared to planned vaginal delivery (PVD) is limited. Major differences are unlikely, but data is insufficient for definitive conclusions.

    Area of Science:

    • Obstetrics and Gynecology
    • Maternal-Fetal Medicine
    • Evidence-Based Medicine

    Background:

    • Cesarean delivery (CD) rates are a global concern.
    • Cesarean delivery on maternal request (CDMR) is an emerging, though poorly defined, indication for CD.
    • Understanding the comparative outcomes of CDMR versus planned vaginal delivery (PVD) is crucial for clinical decision-making.

    Purpose of the Study:

    • To systematically review the evidence on CD trends and incidence.
    • To compare maternal and infant outcomes of CDMR versus PVD.
    • To identify factors influencing CDMR outcomes and suggest future research directions.

    Main Methods:

    • Comprehensive literature search of MEDLINE, Embase, and Cochrane resources from 1990 to present.
    • Inclusion of studies comparing CDMR (or proxies) with PVD.

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  • Data abstraction and verification by two independent reviewers.

    • Main Results:

    • Limited studies directly address CDMR, necessitating reliance on indirect evidence with significant limitations.
    • While some individual outcome differences may exist, major differences between CDMR and PVD are not evident.
    • Evidence is insufficient to definitively conclude the absence of differences or to identify factors modifying outcomes.

    Conclusions:

    • The current evidence base regarding CDMR is significantly limited by its indirect nature and lack of direct relevance.
    • Future research requires standardized terminology, minimum data sets, improved study designs, and comprehensive outcome assessments.
    • Addressing confounders and considering both short- and long-term outcomes are essential for future studies.