Indications for Primary Cesarean Deliveries and Their Association With Maternal Medical Comorbidities [17P]. (May 2020)

• Record Type: Journal Article
• Authors: Izewski, Joanna; Morgan, Jessica C.; Whelan, Anna R; Wheatley, Catherine; Buhimschi, Catalin; Ford, Catherine E.
• Is Part Of: Obstetrics and gynecology. Volume 135(2020)Supplement 1
• Publication Date: 2020-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000663908.41261.6c
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Abnormal fetal heart tracing (FHT) remains one of the most common indications for primary cesarean delivery (PCD) in the United States. Literature suggests a possible association between maternal medical comorbidities and increased risk of cesarean delivery. This study aims to examine PCD for abnormal FHT stratified by various chronic and pregnancy-related medical comorbidities. METHODS: We used a retrospective cohort study design. Following IRB approval, electronic medical records were queried for all cesarean deliveries (n=666) performed at a single University hospital from January 1, to December 31, 2018. Data collected included maternal demographic, medical, and delivery information. Parametric and non-parametric tests were used for data analysis. RESULTS: Out of all cesarean deliveries, 357 surgeries were identified as PCDs. Most common maternal medical comorbidities included chronic hypertension (HTN) (11%, 39/357), pre-gestational diabetes mellitus (DM) (2.5%, 9/357), gestational HTN (9.5%, 34/357), preeclampsia without severe features (SF) (5%, 18/357), preeclampsia with SF (15%, 53/357), gestational DM (9.5%, 34/357). Subjects with chronic HTN (P=.003) and pre-gestational DM (P=.006) had a statistically significant higher rate of PCD for abnormal FHT. No difference was found for all other medical comorbidities. CONCLUSION: Our study suggests that patients with pre-existing medical comorbidities may have a statistically significant higher rate of PCD for abnormal FHT than other pregnancy-related medical comorbidities. Further prospective studies are needed to confirm this potential association and possibly aid in improving preventative measures for reducing PCD.