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Prelabour caesarean section following IVF/ICSI in older-term nulliparous women: too precious to push?
E Gillet1, E Martens, G Martens
1Department of Obstetrics & Gynaecology, University Hospital, Vrije Universiteit (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium. evy.gillet@vub.ac.be
Objective:
To compare prelabour caesarean section (CS) rates in older nulliparous women with a term singleton baby in cephalic presentation conceiving spontaneously and through IVF/ICSI. When the latter women would ask for CS, how willing are gynaecologists to comply with that request?
Methods:
A population-based retrospective (1995-2009) cohort study, conducted in Northern Belgium. A comparison of 1,866 nulliparous women pregnant after IVF/ICSI and 15,228 controls is made. An anonymous postal questionnaire is sent to all Belgian gynaecologists.
Result:
Both groups are comparable with respect to maternal age, gestational age, and birth weight. Prelabour CS is more often performed in women who conceived through IVF/ICSI compared to those who conceived spontaneously (9.2% versus 6.3%, P < 0.001). One in five gynaecologists agrees with the maternal request.
Conclusion:
IVF/ICSI pregnancies in older nulliparous women more often end in a prelabour CS and a substantial number of gynaecologists go along with a nonmedical reason for CS.
