Pregnancy outcome and placental pathology in emergent cesarean deliveries for non-reassuring fetal heart rate in laboring versus non-laboring women

Eran Weiner*, Nataly Fainstein, Adam Pomeranz, Letizia Schreiber, Jacob Bar, Michal Kovo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: The objective of this study is to correlate between pregnancy outcome and placental pathology in emergent cesarean deliveries (ECD) for non-reassuring-fetal-heart-rate (NRFHR) performed in women in their active phase of labor versus those performed in non-laboring women. Methods: A retrospective cohort study. Data were reviewed for all pregnancies necessitating ECD for NRFHR between January 2009 and December 2013. Maternal outcome, neonatal outcome, and placental pathology parameters were compared between ECDs performed during active phase of labor and those performed before the active phase of labor (non-labor group). Results: During the study period, a total of 661 ECDs were performed due to NRFHR. Compared with the active labor group (n = 335), the non-labor group (n = 326) had more pre-eclampsia (p = 0.033), small for gestational age (SGA) (p = 0.016), and preterm labor (p < 0.001). Worse composite neonatal outcome was observed in the non-labor group compared with the active labor group, p < 0.001. By a stepwise logistic regression model, non-labor was independently associated with adverse neonatal outcome (1.88 OR CI; 1.19–2.96, p = 0.007). Placental inflammatory lesions were more common in the active labor group (p= 0.043), and abnormal cord insertions were more common in the non-labor group (p = 0.002) as well as placental weight <10th% (p = 0.019). Conclusion: Higher rate of pregnancy complications, abnormal cord insertion, smaller placentas, and worse neonatal outcome are associated with ECD for NRFHR when performed before the phase of active labor.

Original languageEnglish
Pages (from-to)3089-3093
Number of pages5
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume29
Issue number19
DOIs
StatePublished - 1 Oct 2016

Keywords

  • Active labor
  • emergent cesarean deliveries
  • neonatal outcome
  • non-reassuring fetal heart rate
  • placental pathology

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