Route of delivery in women with stillbirth: Results from the stillbirth collaborative research network

Annelee Boyle, Jessica P. Preslar, Carol J R Hogue, Robert M. Silver, Uma M. Reddy, Robert L. Goldenberg, Barbara J. Stoll, Michael W. Varner, Deborah L. Conway, George Saade, Radek Bukowski, Donald J. Dudley

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

OBJECTIVE: To describe delivery management of singleton stillbirths in a population-based, multicenter case series. METHODS: We conducted a retrospective chart review of 611 women with singleton stillbirths at 20 weeks of gestation or greater from March 2006 to September 2008. Medical and delivery information was abstracted from medical records. Both antepartum and intrapartum stillbirths were included; these were analyzed both together and separately. The primary outcome was mode of delivery. Secondary outcomes included induction of labor and indications for cesarean delivery. Indications for cesarean delivery were classified as obstetric (abnormal fetal heart tracing before intrapartum demise, abruption, coagulopathy, uterine rupture, placenta previa, or labor dystocia) or nonobstetric (patient request, repeat cesarean delivery, or not documented). RESULTS: Of the 611 total cases of stillbirth, 93 (15.2%) underwent cesarean delivery, including 43.0% (46/107) of women with prior cesarean delivery and 9.3% (47/ 504) of women without prior cesarean delivery. No documented obstetric indication was evident for 38.3% (18/47) of primary and 78.3% (36/46) of repeat cesarean deliveries. Labor induction resulted in vaginal delivery for 98.5% (321/326) of women without prior cesarean delivery and 91.1% (41/45) of women with a history of prior cesarean delivery, including two women who had uterine rupture. Among women with a history of prior cesarean delivery who had spontaneous labor, 74.1% (20/27) delivered vaginally, with no cases of uterine rupture. CONCLUSION: Women with stillbirth usually delivered vaginally regardless of whether labor was spontaneous or induced or whether they had a prior cesarean delivery. However, 15% underwent cesarean delivery, often without a documented obstetric indication.

Original languageEnglish (US)
Pages (from-to)693-698
Number of pages6
JournalObstetrics and Gynecology
Volume129
Issue number4
DOIs
StatePublished - 2017
Externally publishedYes

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Stillbirth
Uterine Rupture
Research
Induced Labor
Obstetrics
Placenta Previa
Dystocia
Fetal Heart
Medical Records
Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Boyle, A., Preslar, J. P., Hogue, C. J. R., Silver, R. M., Reddy, U. M., Goldenberg, R. L., ... Dudley, D. J. (2017). Route of delivery in women with stillbirth: Results from the stillbirth collaborative research network. Obstetrics and Gynecology, 129(4), 693-698. https://doi.org/10.1097/AOG.0000000000001935

Route of delivery in women with stillbirth : Results from the stillbirth collaborative research network. / Boyle, Annelee; Preslar, Jessica P.; Hogue, Carol J R; Silver, Robert M.; Reddy, Uma M.; Goldenberg, Robert L.; Stoll, Barbara J.; Varner, Michael W.; Conway, Deborah L.; Saade, George; Bukowski, Radek; Dudley, Donald J.

In: Obstetrics and Gynecology, Vol. 129, No. 4, 2017, p. 693-698.

Research output: Contribution to journalArticle

Boyle, A, Preslar, JP, Hogue, CJR, Silver, RM, Reddy, UM, Goldenberg, RL, Stoll, BJ, Varner, MW, Conway, DL, Saade, G, Bukowski, R & Dudley, DJ 2017, 'Route of delivery in women with stillbirth: Results from the stillbirth collaborative research network', Obstetrics and Gynecology, vol. 129, no. 4, pp. 693-698. https://doi.org/10.1097/AOG.0000000000001935
Boyle, Annelee ; Preslar, Jessica P. ; Hogue, Carol J R ; Silver, Robert M. ; Reddy, Uma M. ; Goldenberg, Robert L. ; Stoll, Barbara J. ; Varner, Michael W. ; Conway, Deborah L. ; Saade, George ; Bukowski, Radek ; Dudley, Donald J. / Route of delivery in women with stillbirth : Results from the stillbirth collaborative research network. In: Obstetrics and Gynecology. 2017 ; Vol. 129, No. 4. pp. 693-698.
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abstract = "OBJECTIVE: To describe delivery management of singleton stillbirths in a population-based, multicenter case series. METHODS: We conducted a retrospective chart review of 611 women with singleton stillbirths at 20 weeks of gestation or greater from March 2006 to September 2008. Medical and delivery information was abstracted from medical records. Both antepartum and intrapartum stillbirths were included; these were analyzed both together and separately. The primary outcome was mode of delivery. Secondary outcomes included induction of labor and indications for cesarean delivery. Indications for cesarean delivery were classified as obstetric (abnormal fetal heart tracing before intrapartum demise, abruption, coagulopathy, uterine rupture, placenta previa, or labor dystocia) or nonobstetric (patient request, repeat cesarean delivery, or not documented). RESULTS: Of the 611 total cases of stillbirth, 93 (15.2{\%}) underwent cesarean delivery, including 43.0{\%} (46/107) of women with prior cesarean delivery and 9.3{\%} (47/ 504) of women without prior cesarean delivery. No documented obstetric indication was evident for 38.3{\%} (18/47) of primary and 78.3{\%} (36/46) of repeat cesarean deliveries. Labor induction resulted in vaginal delivery for 98.5{\%} (321/326) of women without prior cesarean delivery and 91.1{\%} (41/45) of women with a history of prior cesarean delivery, including two women who had uterine rupture. Among women with a history of prior cesarean delivery who had spontaneous labor, 74.1{\%} (20/27) delivered vaginally, with no cases of uterine rupture. CONCLUSION: Women with stillbirth usually delivered vaginally regardless of whether labor was spontaneous or induced or whether they had a prior cesarean delivery. However, 15{\%} underwent cesarean delivery, often without a documented obstetric indication.",
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AU - Silver, Robert M.

AU - Reddy, Uma M.

AU - Goldenberg, Robert L.

AU - Stoll, Barbara J.

AU - Varner, Michael W.

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AU - Saade, George

AU - Bukowski, Radek

AU - Dudley, Donald J.

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N2 - OBJECTIVE: To describe delivery management of singleton stillbirths in a population-based, multicenter case series. METHODS: We conducted a retrospective chart review of 611 women with singleton stillbirths at 20 weeks of gestation or greater from March 2006 to September 2008. Medical and delivery information was abstracted from medical records. Both antepartum and intrapartum stillbirths were included; these were analyzed both together and separately. The primary outcome was mode of delivery. Secondary outcomes included induction of labor and indications for cesarean delivery. Indications for cesarean delivery were classified as obstetric (abnormal fetal heart tracing before intrapartum demise, abruption, coagulopathy, uterine rupture, placenta previa, or labor dystocia) or nonobstetric (patient request, repeat cesarean delivery, or not documented). RESULTS: Of the 611 total cases of stillbirth, 93 (15.2%) underwent cesarean delivery, including 43.0% (46/107) of women with prior cesarean delivery and 9.3% (47/ 504) of women without prior cesarean delivery. No documented obstetric indication was evident for 38.3% (18/47) of primary and 78.3% (36/46) of repeat cesarean deliveries. Labor induction resulted in vaginal delivery for 98.5% (321/326) of women without prior cesarean delivery and 91.1% (41/45) of women with a history of prior cesarean delivery, including two women who had uterine rupture. Among women with a history of prior cesarean delivery who had spontaneous labor, 74.1% (20/27) delivered vaginally, with no cases of uterine rupture. CONCLUSION: Women with stillbirth usually delivered vaginally regardless of whether labor was spontaneous or induced or whether they had a prior cesarean delivery. However, 15% underwent cesarean delivery, often without a documented obstetric indication.

AB - OBJECTIVE: To describe delivery management of singleton stillbirths in a population-based, multicenter case series. METHODS: We conducted a retrospective chart review of 611 women with singleton stillbirths at 20 weeks of gestation or greater from March 2006 to September 2008. Medical and delivery information was abstracted from medical records. Both antepartum and intrapartum stillbirths were included; these were analyzed both together and separately. The primary outcome was mode of delivery. Secondary outcomes included induction of labor and indications for cesarean delivery. Indications for cesarean delivery were classified as obstetric (abnormal fetal heart tracing before intrapartum demise, abruption, coagulopathy, uterine rupture, placenta previa, or labor dystocia) or nonobstetric (patient request, repeat cesarean delivery, or not documented). RESULTS: Of the 611 total cases of stillbirth, 93 (15.2%) underwent cesarean delivery, including 43.0% (46/107) of women with prior cesarean delivery and 9.3% (47/ 504) of women without prior cesarean delivery. No documented obstetric indication was evident for 38.3% (18/47) of primary and 78.3% (36/46) of repeat cesarean deliveries. Labor induction resulted in vaginal delivery for 98.5% (321/326) of women without prior cesarean delivery and 91.1% (41/45) of women with a history of prior cesarean delivery, including two women who had uterine rupture. Among women with a history of prior cesarean delivery who had spontaneous labor, 74.1% (20/27) delivered vaginally, with no cases of uterine rupture. CONCLUSION: Women with stillbirth usually delivered vaginally regardless of whether labor was spontaneous or induced or whether they had a prior cesarean delivery. However, 15% underwent cesarean delivery, often without a documented obstetric indication.

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