- 1. The indication of cesarean delivery in preterm pregnancy can be based on three proposals. They include:
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Medically indicated cesarean section.
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On mother’s request.
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Convenience and preference of the physician.
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All of the above are correct.
- 2. Cesarean section in preterm pregnancy also presents a particular problem related to surgical technique, because:
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The uterine wall is particularly thinner.
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The lower segment may not be formed.
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Horizontal incision may be required.
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Due to the incision, there is increased risk of uterine rupture in the postpartum period.
- 3. Regarding the fetal trauma at birth and maternal outcomes, it is true that:
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There is a significant increase in fetal trauma with vaginal delivery.
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There is no difference in morbidity for women undergoing cesarean section or vaginal delivery.
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There is no difference in fetal trauma between cesarean section and vaginal delivery.
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There is less morbidity among women undergoing cesarean delivery.
- 4. The concept of planned cesarean section in preterm deliveries implies:
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Accurately diagnosing, and performing a C-section early in the period of labor, or right before it.
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Reduced neonatal morbidity and mortality.
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Perform a cesarean section at least 12 hours before the start of labor.
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Indication of cesarean section if there is no progress with vaginal delivery.
- 5. Regarding cesarean delivery and prematurity, the recommendation is:
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The patient’s request determines the indication, on the account of autonomy.
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Planned cesarean section in preterm fetuses in cephalic presentation should not be indicated with the purpose of fetal protection.
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Is indicated for convenience and preference of the physician.
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There is no specific recommendation and the procedure is at the discretion of the obstetrician.
Answers to clinical scenario: update on elective cesarean section for term breech delivery [published in RAMB 2015; 61(5)]
1. Regarding term breech delivery, it is correct to affirm that:
Nulliparity is an associated factor (Alternative C ).
2. The term breech trial (TBT), which compared the elective cesarean section with planned vaginal delivery, found:
Reduced risk of neonatal hypotonia with cesarean delivery (Alternative A ).
3. In maternal morbidity and mortality, comparing the elective cesarean section with planned vaginal delivery, it can be said that:
Results are controversial (Alternative D ).
4. Regarding neonatal morbidity and mortality, comparing the elective cesarean section with planned vaginal delivery, it can be said that:
Results are controversial (Alternative B ).
5. What is the recommendation for the mode of delivery in patients with a term breech pregnancy?
Planned vaginal delivery is recommended, in selected cases, and under ideal conditions (professionals experienced in maneuvers for breech presentation) (Alternative A ).
Publication Dates
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Publication in this collection
Nov-Dec 2015