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TUESDAY, Aug. 31 (HealthDay News) -- Almost a third of deliveries in the United States are by cesarean section, and more than 30 percent of cesareans can be attributed to pre-labor repeat cesarean delivery due to a previous uterine scar, according to research published online Aug. 13 in the American Journal of Obstetrics & Gynecology.
Jun Zhang, M.D., of the National Institutes of Health in Bethesda, Md., and colleagues conducted a study of cesarean delivery practices using data from 19 hospitals across the United States. Electronic medical records from 2002 to 2008 were used as a data source.
The researchers found that the overall rate of cesarean section in the sample hospitals was 30.5 percent. For nulliparous women, the rate was 31.2 percent. Multiparous women, who had approximately the same proportion of cesarean sections, mostly had planned pre-labor repeat cesarean sections. Other factors associated with a higher percentage of cesarean sections were obesity and older age, the latter likely in part due to repeat pre-labor cesarean sections. Among women attempting vaginal delivery after previous cesarean (28.8 percent), 57.1 percent of the women in the sample were successful. About half of cesareans for dystocia during induced labor were performed before 6 cm of cervical dilation.
"To make a significant impact on the high cesarean delivery rate in the United States, the focus should be preventing unnecessary primary cesarean deliveries from several aspects," the authors write. "Cesarean section for dystocia should be avoided before active phase of labor is established particularly in nulliparous women, induced labor, and vaginal-birth-after-previous-cesarean attempts."
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