SPONTANEOUS LABOR RATE IN ELECTIVE REPEAT CESAREAN SECTION AT 38 WEEKS VERSUS 39 WEEKS OF GESTATION WITH MATERNAL AND NEONATAL OUTCOME IN NAN HOSPITAL
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Abstract
BACKGROUND: The American College of Obstetricians and Gynecologists (ACOG) recommends planned elective repeat cesarean section (ERCS) should occur after 39 completed weeks of gestation due to the lowest rate of adverse maternal and neonatal outcome. However, the fetal lung maturity was different according to gestational age and ethnicity, and some studies found planned ERCS before 39 completed weeks of gestation not affected to maternal and neonatal outcomes.
OBJECTIVE: To study the spontaneous labor rate in planned ERCS at 38 weeks versus 39 weeks of gestation with compared maternal and neonatal outcome in Nan hospital.
METHODS: This was a retrospective analysis study. We conducted the singleton pregnant woman who had a history of repeated CS at 37 – 40 weeks of gestation between 1 Oct. 2020 and 30 Sep. 2022.
RESULTS: A total of 524 pregnant women, 377 women were performed planned ERCS at 38 weeks of gestation and 147 women were performed planned ERCS at 39 weeks of gestation. The spontaneous labor rate was 20.70 % and 60.50 % in planned ERCS at 38 and 39 weeks of gestation, respectively (p < 0.001). There were no significant differences in maternal and neonatal outcome except mean of birth weight. Birth weight at 39 weeks of gestation was higher than 38 weeks of gestation (p = 0.021). Moreover, this study found the delivery outside working hours and referral rate were increased in planned ERCS at 39 weeks of gestation with statistically significant.
CONCLUSION AND RECOMMENDATION: The spontaneous labor rate was significant higher in planned ERCS at 39 weeks of gestation compared with planned ERCS at 38 weeks of gestation. The maternal and neonatal outcome not significant difference between these groups. Planned ERCS at 38 - 38 6/7 weeks of gestation may be a suitable choice to decreased spontaneous labor rate.
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