Maternal mortality and cesarean delivery: An analytical observational study
Article first published online: 7 MAR 2010
© 2010 The Authors. Journal compilation © 2010 Japan Society of Obstetrics and Gynecology
Journal of Obstetrics and Gynaecology Research
Volume 36, Issue 2, pages 248–253, April 2010
How to Cite
Kamilya, G., Seal, S. L., Mukherji, J., Bhattacharyya, S. K. and Hazra, A. (2010), Maternal mortality and cesarean delivery: An analytical observational study. Journal of Obstetrics and Gynaecology Research, 36: 248–253. doi: 10.1111/j.1447-0756.2009.01125.x
- Issue published online: 25 MAR 2010
- Article first published online: 7 MAR 2010
- Received: January 21 2008.Accepted: April 20 2009.
- cesarean delivery;
- maternal mortality;
- vaginal delivery
Aim: Pregnant women and their doctors need to know the maternal risks associated with different methods of delivery. There are few publications with ideal study design and adequate power to establish the relationship between maternal mortality and mode of delivery. The present retrospective cohort study was undertaken to evaluate the intrinsic risk of maternal death, directly attributed to cesarean delivery (CD) compared to vaginal delivery (VD), and to evaluate further the differential risk associated with antepartum and intrapartum CD.
Methods: After exclusion of medical or obstetric comorbidities, all deliveries, either vaginal or cesarean, were critically analyzed. The surviving mothers who had either method of delivery represented the two comparative groups. In the same period, relevant clinical information of every maternal death was noted.
Results: Twenty seven mothers died among the 13 627 CD mothers and 19 died among 30 215 VD mothers. CD was associated with a 3.01-fold increase in the risk of maternal mortality, compared with VD. The risk of antepartum CD differed from intrapartum CD (OR 1.73 vs OR 4.86). There was a significantly increased risk of maternal death from complications of anesthesia, puerperal infection and venous thromboembolism. The risk of death from postpartum hemorrhage did not differ significantly (95% CI 0.7–3.95).
Conclusion: CD is increasingly perceived as a low-risk procedure. However, the present study clearly demonstrates that the risk of maternal death due to CD is significantly high, particularly when performed in labor. Therefore, CD should only be practiced when conditions clearly demand it.