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Malpresentation in low- and middle-income countries: Associations with perinatal and maternal outcomes in the Global Network
| Content Provider | Scilit |
|---|---|
| Author | Duffy, Cassandra R. Moore, Janet L. Saleem, Sarah Tshefu, Antoinette Bose, Carl L. Chomba, Elwyn Carlo, Waldemar A. Garces, Ana L. Krebs, Nancy F. Hambidge, K. Michael Goudar, Shivaprasad Derman, Richard J. Patel, Archana Hibberd, Patricia L. Esamai, Fabian Liechty, Edward A. Wallace, Dennis D. McClure, Elizabeth M. Goldenberg, Robert L. |
| Copyright Year | 2018 |
| Description | Journal: Acta Obstetricia et Gynecologica Scandinavica Introduction Uncertainty exists regarding the impact of malpresentation on pregnancy outcomes and the optimal mode of delivery in low‐ and middle‐income countries. We sought to compare outcomes between cephalic and non‐cephalic pregnancies. Material and methods Using the NICHD Global Network's prospective, population‐based registry of pregnancy outcomes from 2010‐2016, we studied outcomes in 436,112 singleton pregnancies. Robust Poisson regressions were used to estimate the risk of adverse outcomes associated with malpresentation. We examined rates of cesarean delivery for malpresentation and compared outcomes between cesarean and vaginal delivery by region. Results Across all regions, stillbirth and neonatal mortality rates were higher among deliveries with malpresentation. In adjusted analysis, malpresentation was significantly associated with stillbirth (adjusted relative risk (aRR) 4.0, 95% confidence interval (CI); 3.7 to 4.5) and neonatal mortality (aRR 2.3, 95% CI; 2.1 to 2.6). Women with deliveries complicated by malpresentation had higher rates of morbidity and mortality. Rates of cesarean delivery for malpresentation ranged from 27% to 87% among regions. Compared to cesarean, vaginal delivery for malpresentation was associated with increased maternal risk, especially postpartum hemorrhage (aRR 5.0, 95% CI; 3.6 to 7.1). Conclusions In a cohort of deliveries in low‐ and middle‐income countries, malpresentation was associated with increased perinatal and maternal risk. Further research is needed to determine the best management of these pregnancies. This article is protected by copyright. All rights reserved. |
| Ending Page | 308 |
| Starting Page | 300 |
| ISSN | 00221295 |
| e-ISSN | 16000412 |
| DOI | 10.1111/aogs.13502 |
| Journal | Acta Obstetricia et Gynecologica Scandinavica |
| Issue Number | 3 |
| Volume Number | 98 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2018-11-10 |
| Access Restriction | Open |
| Subject Keyword | Journal: Acta Obstetricia et Gynecologica Scandinavica Obstetrics and Gynecology Breech Presentation Labor Presentation Obstetric Delivery Cesarean Section Pregnancy Outcomes Developing Countries |
| Content Type | Text |
| Resource Type | Article |
| Subject | Obstetrics and Gynecology |
