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Am J Obstet Gynecol. 2005 Jun;192(6):1872-5; discussion 1875-6.

Repeat cesarean section and primary elective cesarean section: recently trained obstetrician-gynecologist practice patterns and opinions.

Author information

  • 1Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University Medical Center, Maywood, IL 60153, USA. kkenton@lumc.edu

Abstract

OBJECTIVE:

This study was undertaken to determine opinions of obstetrician-gynecologists regarding vaginal birth after cesarean (VBAC) section and elective cesarean section.

STUDY DESIGN:

A questionnaire was administered to obstetrician-gynecologists attending 2 review courses.

RESULTS:

Of 500 obstetrician-gynecologists, 304 completed the survey for a response rate of 61%. Most (92%) counseled VBAC candidates differently, and 84% quoted differential VBAC completion rates on the basis of the indication for prior cesarean section. Uterine rupture was virtually always discussed (99%). Pelvic floor risks were infrequently discussed with urinary incontinence, pelvic organ prolapse, and fecal incontinence discussed by less than one third of obstetricians (30%, 28%, and 25%, respectively). Fifty-nine percent of physicians would perform a primary elective cesarean section, and 67% would perform a primary elective cesarean section specifically to prevent pelvic floor disorders.

CONCLUSION:

Two thirds of recent graduates are willing to perform an elective cesarean section to prevent pelvic floor injury. Most offer VBAC; however, less than a third include risk of pelvic floor injury in their informed consent discussions.

PMID:
15970836
[PubMed - indexed for MEDLINE]
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