Case Types -Birth Injury Claims

Birth Injury Cesarean Section Risk Study   Vaginal birth after cesarean section: trial of labor or repeat cesarean section? A decision analysis. Mankuta DD, Leshno MM, Menasche MM, Brezis MM. Department of Obstetrics and Gynecology, Hadassah Hebrew-University Hospital, Jerusalem, Israel. mankuta@yahoo.com OBJECTIVE: The risk of perinatal death associated with labor after previous cesarean section appears higher than with a repeated cesarean section. On the other hand, repeated cesarean sections are associated with increased maternal morbidity and mortality from placental pathologic conditions (previa or accreta) on subsequent pregnancies. The study was undertaken to analyze the decision for a trial of labor or a repeated cesarean section, after a prior cesarean section, with varying desire for an additional pregnancy. STUDY DESIGN: A model was formulated using a decision tree, based on the reported risks of the two approaches. Sensitivity analysis was performed over a variety of probabilities (eg, chance of uterine rupture or neonatal death, chance of rescue cesarean section, desire for an additional pregnancy) and utilities (eg, use of hysterectomy or neonatal death). RESULTS: The model favors a trial of labor if it has a chance of success of 50% or above and if the wish for additional pregnancies after a cesarean section is estimated at near 10% to 20% or above because the delayed risks from a repeated cesarean section are greater than its immediate benefit. The model was robust over a wide range of assumptions. CONCLUSION: An optimal decision for a trial of labor or a repeated cesarean section is substantially determined by the wish for future pregnancies. The default option of a repeated cesarean section is not directly applicable in populations in which family planning often extends over two children. See this study article in full at: http://www2.us.elsevierhealth.com/scripts/om.dll/serve?retrieve=/pii/S0002937803008330& Short text description above was found at Government site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi? cmd=Retrieve&db=PubMed&list_uids=14526300&dopt=Abstract PMID: 14526300 [PubMed - indexed for MEDLINE] GET HELP- Contact our lawyers now if you think a severe violation or negligence has happened in Birth Injury care of someone you know or love. Suffering must be stopped. Let our lawyers inform you of your legal options. You have rights & protections by law !   BE INFORMED      Related NY Birth Injury Reading below Birth Injury Cesarean Section Risk Help Against Fetal Distress Risk Factor for Erb's Palsy Birth Injury Facts, Stats & Law NY & National Birth Injury Help Links