Childern born to repeat caesarean require intensive care

Increase intensive care require in repeated caesarean : Infants born to elective caesarean instead of vaginal delivery are likely to have higher rates of respiratory illness, low blood sugar & may need neonatal intensive care unit (NICU). Whether an elective repeat caesarean delivery is preferable for a woman with history of caesarean delivery is still a controversy.

The fail trail of vaginal delivery carries an increased risk of uterine rupture & impairment of the infant's breathing , obstetricians often favour elective repeat caesarean. While comparing the outcomes of elective caesarean versus vaginal birth. After caesarean delivery, researchers studied 672 women who had one prior caesarean delivery of a single full-term infant without birth defects. They categorised the women into four groups.

1. Elective repeat caesarean before labour begins (239 women)

2. Elective caesarean after onset of labour (104 women)

3. Successful vaginal birth after caesarean (244 women)

4. Failed vaginal birth after caesarean requiring emergency caesarean delivery (85 women)

Researchers found that infants delivered by caesarean had significantly higher admission rates to the neonatal intensive care unit (NICU) compared with those delivered vaginally after caesarean. It was also found that planned repeat caesareans were associated with a higher incidence of neonatal intensive care unit (NICU) admission for treatment of hyperglycemia & administration of oxygen & ventilatory support.

It is more specifically seen in women who failed vaginal birth & required caesarean delivery were most likely to have an infant that experienced distress requiring resuscitation. On the other hand a successful vaginal birth after previous caesarean was associated with the lowest rates of admission to the neonatal intensive care unit (NICU). These infants also require the shortest hospital stays & the lowest incidence of ongoing respiratory support.

These findings argue for greater selectivity in performing a caesarean delivery in the first place & certainly a greater need for counselling before a primary elective caesarean delivery.


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