Mode of delivery and obstetric outcomes in Asia

Evaluation of: Lumbiganon P, Laopaiboon M, Gulmezoglu A et al.: Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-2008. Lancet 375(9713), 490-499 (2010). In a multinational survey of 122 medical facilities in nine Asian countries, the WHO analyzed data on 107,950 deliveries. Compared with spontaneous vaginal deliveries, any type of cesarean was associated with a 2.7-14.5-fold increase in the odds of the maternal mortality and morbidity index. Antepartum cesarean with indications and intrapartum cesarean demonstrated similar perinatal outcomes when compared with spontaneous vaginal delivery; patients who underwent an intrapartum cesarean without indication had a 2.1-fold increase in the odds of the perinatal mortality and morbidity index. Cesarean delivery decreased perinatal morbidity when performed for noncephalic presentation. Operative vaginal deliveries were also associated with a 2.1-fold increase in the odds of maternal morbidity or mortality with a concomitant 1.9-fold increase in the odds of perinatal morbidity and mortality.