intrapartum cesarean
Conditions
Interventions
Sponsors
The international peace maternity and child health hospital
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: 1.Singleton primiparous women at =37 weeks of gestation who underwent cesarean delivery.
Exclusion criteria
Exclusion criteria: 1. Maternal factors Severe pelvic deformity resulting in absolute cephalopelvic disproportion (anterior-posterior diameter of the pelvic inlet =8 cm), active bleeding from uterine rupture, active genital herpes lesions obstructing the birth canal, invasive cervical cancer (clinical stage =IIB requiring immediate pregnancy termination and radiotherapy), uncontrollable massive obstetric hemorrhage (ineffective uterotonics with blood loss >1500 mL or sudden Hb decrease >3 g/dL), NYHA class III–IV cardiac dysfunction. 2.Fetal factors Transverse lie or shoulder presentation (regardless of gestational age), mentoposterior position (mechanical obstruction due to face presentation), compound presentation with irreducible umbilical cord prolapse and fetal heart rate 1500 mL), grade IV placental abruption (abruption area >50% complicated by DIC or uteroplacental apoplexy), rupture of vasa previa in velamentous insertion (vaginal bleeding plus sudden fetal heart rate deceleration), vasa previa (uncorrected position anterior to the presenting part). 4.Special infectious and medical contraindications Uncontrolled HIV infection (viral load >1000 copies/mL without standard antiretroviral therapy), active tuberculous meningitis (to avoid brain herniation caused by intracranial pressure fluctuations during labor), preeclampsia or severe preeclampsia complicated by organ injury (cerebrovascular accident, HELLP syndrome, or acute renal failure). 5.Women without pregnancy complications such as diabetes mellitus, hypertension, or thyroid disorders;without complications during labor induction including fetal distress (per FIGO cardiotocography criteria), intrapartum fever (=38°C), or premature rupture of membranes >24 hours;who underwent cesarean section only due to failed induction (ineffective uterine contractions or arrested cervical dilation).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of Postpartum Hemorrhage; | — |
Secondary
| Measure | Time frame |
|---|---|
| Neonatal outcomes: asphyxia, birth injuries, NICU admission rate and length of stay, perinatal mortality;Short-term Postoperative Complications;Prevention of Postpartum Hemorrhage and Usage of Postpartum Hemorrhage Rescue Measures; | — |
Countries
China
Contacts
Public ContactSu Xiaoxia
The international peace maternity and child health hospital
Outcome results
None listed