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Clinical and Experimental Obstetrics & Gynecology  2018, Vol. 45 Issue (3): 391-395    DOI: 10.12891/ceog4133.2018
Original Research Previous articles | Next articles
Repeat cesarean delivery in the 39-week rule era: outcomes at a community based hospital
K. Roloff1, *(), A. Gray2, V.J. Guillermo1
1 Department of Women's Health, Arrowhead Regional Medical Center (ARMC), Colton, CA, USA
2 Department of Pediatrics, University of California San Francisco, Fresno, CA, USA
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Objective: To compare adverse perinatal outcomes between scheduled and unscheduled repeat cesarean deliveries performed prior to 39 weeks' gestation. Materials and Methods: The authors performed a single-center, retrospective cohort study comparing scheduled, and unscheduled repeat cesarean deliveries. Outcomes compared included (1) adverse operative injuries, (2) excessive blood loss, defined as drop in Hg greater than then 97% (3.6 g), or need for blood transfusion, and (3) adverse neonatal outcome (low 5-minute Apgar, or NICU admission). The presence of any adverse event, and the number of adverse events per 100 deliveries were compared between scheduled and unscheduled cases. Results: A total of 724 repeat cesarean deliveries were reviewed, of which 48.9% (n = 354) were unscheduled. There were significantly more adverse outcomes in the unscheduled cesarean cohort (32 per 100 deliveries), compared to the scheduled cesarean cohort (13 per 100 deliveries) (p < 0.001). When compared with those undergoing scheduled cesarean deliveries, women with unscheduled repeat cesarean deliveries were noted to have increased adverse outcomes (OR 3.11, 95% CI 2.04-4.74). Conclusion: Almost half (48.9%) of patients with previous cesarean deliveries deliver for either maternal or fetal indication prior to 39 weeks of gestation, and carry greater risk for adverse perinatal outcome.
Key words:  Labor and delivery      Repeat cesarean delivery      Repeat cesarean section      Adverse perinatal outcome      Unscheduled cesarean delivery     
Published:  10 June 2018     
*Corresponding Author(s):  K. ROLOFF     E-mail:

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K. Roloff, A. Gray, V.J. Guillermo. Repeat cesarean delivery in the 39-week rule era: outcomes at a community based hospital. Clinical and Experimental Obstetrics & Gynecology, 2018, 45(3): 391-395.

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[1] Anna M. Rubinshtein, Oleg V. Golyanovskiy. Obstetric outcomes in women of advanced maternal age after assisted reproduction[J]. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(4): 893-900.
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