MedWire News: Persevering for a vaginal delivery if labor stalls during the active phase can avoid the maternal complications associated with cesarean section, with no detrimental effect on neonatal outcomes, research indicates.

"One-third of all first-time cesareans are performed due to active-phase arrest during labor, which contributes to approximately 400,000 surgical births per year," said senior author Aaron Caughey (University of California, San Francisco, USA).

"In our study, we found that just by being patient, one-third of those women could have avoided the more dangerous and costly surgical approach."

The investigators studied data on 1,014 women who experienced active phase arrest during labor. Among these women, 335 (33 percent) went on to deliver vaginally, while the rest underwent cesarean deliveries.

Analysis revealed that cesarean delivery was associated with an increased risk for maternal complications, including endomyometrisis (odds ratio = 48.4) and postpartum hemorrhage (odds ratio = 5.2). However, the mode of delivery showed no significant impact on perinatal outcomes such as the rate of admission to neonatal intensive care and 5-minute Apgar scores.

"Given the extensive data on the risk for cesarean deliveries, both during the procedure and for later births, prevention of the first cesarean delivery should be given high priority," Caughey recommended.

Journal abstract