Open AccessHistoric cohort study on mode of delivery of a macrosomic baby: the women's point of view
Author(s) -
Vercellini Paolo,
Fumagalli Monica,
Consonni Dario,
Braud Lucrezia,
Barbara Giussy,
Iurlaro Enrico,
Mosca Fabio,
Fedele Luigi
Publication year - 2015
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12723
Subject(s) - medicine , childbirth , vaginal delivery , urinary incontinence , obstetrics , cesarean delivery , cohort , gynecology , pregnancy , surgery , genetics , biology
A historic cohort study was conducted to evaluate satisfaction with childbirth of a macrosomic baby according to mode of delivery. Material and methods All 559 nulliparous women who delivered a neonate weighing >4000 g between 2008 and 2012 were included. The degree of women's satisfaction with childbirth after elective cesarean, vaginal delivery or cesarean during labor was assessed using a five‐level scale. Immediate neonatal and maternal outcomes were retrieved from clinical records. Long‐term maternal outcomes were evaluated using four questionnaires on urinary incontinence, anal incontinence, and sexual functioning. Results Ninety‐nine women underwent elective cesarean, whereas 460 attempted a vaginal delivery. In the latter group, 276 women delivered vaginally, whereas 184 underwent a cesarean during labor. Long‐term outcomes were assessed in 273 women (49%; elective cesarean, n = 55; vaginal delivery, n = 135; cesarean in labor, n = 83) after a mean 3‐year follow up. The proportion of long‐term stress or mixed urinary incontinence was, respectively, 8%, 34%, and 12%, whereas that of anal incontinence was 7%, 19%, and 6%. Sexual functioning was similar in the three groups. No major neonatal complications were observed. When pooling the vaginal delivery and the cesarean in labor groups, the likelihood of being satisfied with childbirth was 63% in the “attempted vaginal delivery” group and 85% in the elective cesarean group (adjusted risk ratio, 0.72; 95% CI 0.61–0.84). Conclusions About one‐third of women attempting a vaginal delivery of a macrosomic baby, would choose an elective cesarean if they could turn back time.