Presented at the Neonatal Society Spring Meeting 2019.
Authors: A Glazewska-Hallin, M Hickland, J Carter, H Watson, L Story, A Shennan
Department of Women and Children’s Health, King’s College London
Preterm deliveries have multiple aetiologies and management is dependent on
A retrospective data analysis of women attending preterm surveillance clinic at St Thomas’ Hospital. Women who had a preterm birth or late miscarriage following a full dilatation Caesarean section and emergency Caesarean sections were identified. The control group comprised of women with a previous spontaneous preterm birth or late miscarriage with any mode of delivery. The primary outcome was delivery prior to 30 weeks gestation. A
189 women experienced a subsequent spontaneous preterm birth or late miscarriage following an emergency Caesarean of which 64 received a TVC. There were 942 controls, of which 154 received TVS and 5/154 delivered <30 weeks (3%). 19/54 women in the FDCS group received a vaginal cerclage in their third pregnancy (including both history and ultrasound indicated) and significantly more of these women delivered before 30 weeks compared to controls (53% vs 3%, p<0.0001). In the emergency Caesarean group, 31/64 with a TVC delivered prior to 30 weeks, significantly less than controls (48% vs 3%, p<0.0001).
Both first stage emergency Caesareans and FDCS increase the risk of subsequent preterm birth, with a high incidence of delivery prior to 30 weeks. There is a higher TVC failure rate in these women. Further research is necessary to elucidate if ultrasound or MRI can predict
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- Watson HA, Carter J, David AL, Seed PT, Shennan AH. Full dilation cesarean section: a risk factor for recurrent second-trimester loss and preterm birth. Acta Obstet Gynecol Scand. 2017;96(9):1100–5.
Senior author supporting presentation on day of meeting: Dr Karen Luyt
Corresponding author e-mail address: firstname.lastname@example.org