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Continuous Telemetric In Utero Tracheal Pressure Measurements in Fetal Lambs
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Obstetrical interventions for term first deliveries in the US.

Cande V Ananth1, Allen J Wilcox, Cynthia Gyamfi-Bannerman

  • 1Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY, USA. cande.ananth@columbia.edu

Paediatric and Perinatal Epidemiology
|August 13, 2013
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Summary

Nearly half of first-time mothers delivering at term had interventions like labor induction or cesarean. A significant portion of these interventions lacked a clear clinical indication, suggesting potential overuse.

Keywords:
caesarean deliveryelective deliverieslabour inductionobstetrical interventions

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Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Epidemiology

Background:

  • Rising rates of labor induction and cesarean delivery.
  • Limited understanding of non-medically indicated interventions.
  • Need to characterize maternal profiles associated with interventions.

Purpose of the Study:

  • To determine the prevalence of indicated and non-indicated interventions in US term deliveries.
  • To identify characteristics of women receiving these interventions.
  • To analyze trends in labor induction and cesarean rates.

Main Methods:

  • Retrospective study of 2.35 million primiparous women in the US (2005-2008).
  • Utilized US birth certificate data (2003 revision) for intervention classification.
  • Defined 'indicated' and 'non-indicated' delivery categories based on clinical criteria.

Main Results:

  • 50% of term first births involved intervention; 26% of all deliveries were non-indicated interventions.
  • Interventions were more frequent on weekdays.
  • Non-indicated interventions were more prevalent in socially advantaged populations.

Conclusions:

  • Approximately 25% of US term first deliveries had indicated interventions.
  • Another 25% received interventions without recorded clinical indications.
  • These figures are likely underestimates, highlighting potential overuse.