Update on cesarean delivery and prematurity

Atualização em cesariana e prematuridade

1. The indication of cesarean delivery in preterm pregnancy can be based on three proposals. They include:

1. Medically indicated cesarean section.

2. On mother’s request.

3. Convenience and preference of the physician.

4. All of the above are correct.

2. Cesarean section in preterm pregnancy also presents a particular problem related to surgical technique, because:

1. The uterine wall is particularly thinner.

2. The lower segment may not be formed.

3. Horizontal incision may be required.

4. Due to the incision, there is increased risk of uterine rupture in the postpartum period.

3. Regarding the fetal trauma at birth and maternal outcomes, it is true that:

1. There is a significant increase in fetal trauma with vaginal delivery.

2. There is no difference in morbidity for women undergoing cesarean section or vaginal delivery.

3. There is no difference in fetal trauma between cesarean section and vaginal delivery.

4. There is less morbidity among women undergoing cesarean delivery.

4. The concept of planned cesarean section in preterm deliveries implies:

1. Accurately diagnosing, and performing a C-section early in the period of labor, or right before it.

2. Reduced neonatal morbidity and mortality.

3. Perform a cesarean section at least 12 hours before the start of labor.

4. Indication of cesarean section if there is no progress with vaginal delivery.

5. Regarding cesarean delivery and prematurity, the recommendation is:

1. The patient’s request determines the indication, on the account of autonomy.

2. Planned cesarean section in preterm fetuses in cephalic presentation should not be indicated with the purpose of fetal protection.

3. Is indicated for convenience and preference of the physician.

4. There is no specific recommendation and the procedure is at the discretion of the obstetrician.

Answers to clinical scenario: update on elective cesarean section for term breech delivery [published in RAMB 2015; 61(5)]

1. Regarding term breech delivery, it is correct to affirm that:

Nulliparity is an associated factor (Alternative C ).

2. The term breech trial (TBT), which compared the elective cesarean section with planned vaginal delivery, found:

Reduced risk of neonatal hypotonia with cesarean delivery (Alternative A ).

3. In maternal morbidity and mortality, comparing the elective cesarean section with planned vaginal delivery, it can be said that:

Results are controversial (Alternative D ).

4. Regarding neonatal morbidity and mortality, comparing the elective cesarean section with planned vaginal delivery, it can be said that:

Results are controversial (Alternative B ).

5. What is the recommendation for the mode of delivery in patients with a term breech pregnancy?

Planned vaginal delivery is recommended, in selected cases, and under ideal conditions (professionals experienced in maneuvers for breech presentation) (Alternative A ).

Publication Dates

• Publication in this collection
  Nov-Dec 2015