XML Feed for RxPG News   Add RxPG News Headlines to My Yahoo!   Javascript Syndication for RxPG News

Research Health World General
 
  Home
 
 Latest Research
 Cancer
 Psychiatry
 Genetics
 Surgery
 Aging
 Ophthalmology
 Gynaecology
 Neurosciences
 Pharmacology
 Cardiology
 Obstetrics
 Infectious Diseases
 Respiratory Medicine
 Pathology
 Endocrinology
 Immunology
 Nephrology
 Gastroenterology
 Biotechnology
 Radiology
 Dermatology
 Microbiology
 Haematology
 Dental
 ENT
 Environment
 Embryology
 Orthopedics
 Metabolism
 Anaethesia
 Paediatrics
 Public Health
 Urology
 Musculoskeletal
 Clinical Trials
 Physiology
 Biochemistry
 Cytology
 Traumatology
 Rheumatology
 
 Medical News
 Health
 Opinion
 Healthcare
 Professionals
 Launch
 Awards & Prizes
 
 Careers
 Medical
 Nursing
 Dental
 
 Special Topics
 Euthanasia
 Ethics
 Evolution
 Odd Medical News
 Feature
 
 World News
 Tsunami
 Epidemics
 Climate
 Business
Search

Last Updated: Sep 22nd, 2006 - 17:02:11

Obstetrics Channel
subscribe to Obstetrics newsletter

Latest Research : Obstetrics

   DISCUSS   |   EMAIL   |   PRINT
Senior obstetrician are less hasty about caesarean sections
Sep 22, 2006, 16:59, Reviewed by: Dr. Priya Saxena

It found that a consultant obstetrician who performed a vaginal assessment was more likely to reverse a decision made by an obstetric trainee for a caesarean and proceed to a safely conducted instrumental delivery.

 
Many emergency caesareans could be prevented by the attendance of a more skilled obstetrician, say senior doctors in this week's BMJ.

They call for better training in instrumental vaginal delivery (use of forceps or ventouse) for obstetric trainees to help reduce rates.

A recent UK study found that decisions made by senior (consultant) obstetric staff are important in determining whether a second stage caesarean section is the best method of delivery for women with delay in advanced labour. It found that a consultant obstetrician who performed a vaginal assessment was more likely to reverse a decision made by an obstetric trainee for a caesarean and proceed to a safely conducted instrumental delivery.

The authors warn that, without increases in junior doctors' experience and recruitment into the specialty, the problems with second stage caesareans will rise.

According to the Royal College of Obstetricians and Gynaecologists audit figures, about 35% of caesareans for singleton pregnancies are performed because of failure to progress in labour, of which a quarter occur at full cervical dilatation. In 55% of these cases no attempt was made to achieve a vaginal birth with either forceps or ventouse. In those births where instrumental delivery was attempted, the audit noted a "failed" rate of 35% for ventouse and 2% for forceps.

Breech and twin deliveries can also lead to second stage caesareans. In the absence of an experienced and skilful obstetrician to perform assisted vaginal breech delivery, women are advised to undergo an emergency caesarean.

For twin deliveries, currently about 10% of second twins are delivered by caesarean section after the first has been delivered vaginally: 10 years ago, the rate was 5%. As many as two thirds of these caesareans are preventable, say the authors.

Despite problems relating to the inexperience of obstetric trainees, the United Kingdom is making great strides in terms of structured training, assessment of competencies, and consultant delivered intrapartum care, they write. Nevertheless, it is essential to recognise the need for obstetricians to maintain and develop their skills if women are to be offered safe alternatives to caesarean section when complications arise in labour.

 

-
 

http://www.bmj.com/

 
Subscribe to Obstetrics Newsletter
E-mail Address:

 



Related Obstetrics News

Medical induction of labor increases risk of amniotic-fluid embolism
Senior obstetrician are less hasty about caesarean sections
Carbon monoxide may be beneficial in pre-eclampsia
Prenatal diagnostic tests decrease the risk of miscarriage
Miscarriage significantly associated with increasing paternal age
Clinical examination not sensitive enough to detect breech babies
Preeclampsia risk reduced by regular multivitamins near time of conception
Why Listeriosis rates are 20-fold higher during pregnancy
Why birth interventions are on the rise
Pregnancy Complications Still High For Women With Diabetes


For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 

© Copyright 2004 onwards by RxPG Medical Solutions Private Limited
Contact Us