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Ryu, Rho, Han, Ha, and Kim: The pros and cons of different modes of delivery at a single institution
Original Article
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(6): 279-285.

Published online: 30 June 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.6.279

The pros and cons of different modes of delivery at a single institution

Ji Won Ryu, MD1, Young Ho Rho, MD1, Sang Won Han, MD2, Hyun Yong Ha, MD2, Euy Hyuk Kim, MD2

1Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.

2National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.

Corresponding author: Euy Hyuk Kim, MD. Department of Obstetrics and Gynecology, National Health Insurance Corporation Ilsan Hospital, 1232 Baekseok 1-dong, Ilsandong-gu, Goyang 410-719, Korea. Tel: +82-31-900-0211, Fax: +82-31-900-0138, raksumi10@gmail.com

Received 17 January 2011       Revised 11 April 2011       Accepted 3 May 2011

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

To compare the postpartum maternal and neonatal effects and complications according to delivery modes.

Methods

Five hundred twenty eight singleton pregnant women, who delivered after 36 gestational weeks in National Health Insurance Corporation Ilsan Hospital between July 2007 and July 2009, were retrospectively analyzed. They were categorized into 3 groups: group A, vaginal delivery; group B, elective cesarean delivery; and group C, emergent cesarean delivery. We evaluated the difference in hemoglobin decrement and postpartum hospital stays, medico-surgical curettage, and antibiotics usage. From the view point of neonates, 1 and 5 minute Apgar scores and Neonatal Intensive Care Unit (NICU) admission rates and meconium aspiration rates were evaluated.

Results

Postpartum hemoglobin decrement and postpartum hospital days were statistically different among the groups, which results were 1.28 vs. 1.88 vs. 2.68 g/dL and 3.5 vs. 5.9 vs. 6.6 days, respectively (p<0.001). Number of out-patient-department follow-up was highest in group C and additional antibiotics usage was highest in group A with statistical significance. The Apgar score was highest in group B (8.0% vs. 3.2% vs. 16.3%, p=0.002). NICU admission rate and meconium aspiration were also lowest in group B (4.5% vs. 0% vs. 7.5%, p=0.001).

Conclusion

Although vaginal delivery showed advantage over blood loss related to procedure, hospital days and number of follow up, elective cesarean delivery has advantage carrying less severe complication of mother and better outcome for the baby than other delivery methods.

Keywords: Cesarean section, Delivery, obstetric, Pregnancy complication

Figures and Tables

Fig. 1
Indications of cesarean section. (A) Elective cesarean section. (B) Emergent cesarean section. CDMR, cesarean delivery on maternal request; PIH, pregnancy induced hypertension; CPD, cephalopelvic disproportion.
kjog-54-279-g001
Table 1
Patient characteristics
kjog-54-279-i001

Values are presented as mean ± standard deviation.

Group A, vaginal delivery; Group B, elective cesarean section; Group C, emergent cesarean section.

Table 2
Delivery outcomes
kjog-54-279-i002

Group A, vaginal delivery; Group B, elective cesarean section; Group C, emergent cesarean section; ICU, intensive care unit; NS, non-significance. aIn case that hemoglobin decrement is larger than 4.

Table 3
Characteristics of neonate
kjog-54-279-i003

Group A, vaginal delivery; Group B, elective cesarean section; Group C, emergent cesarean section; NS, non-significance; AF, amniotic fluid; NICU, neonatal intensive care unit.

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