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Old July 25th 04, 06:07 PM
Chotii
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Default Previous c-section linked with increased risk of stillbirth


"Donna Metler" wrote in message
...

"Ericka Kammerer" wrote in message
...

Add this to another reason to try to limit
unnecessary primary c-sections--apparently, a previous
c-section increases the risk of stillbirth in
subsequent pregnancies. Fortunately, while the
increase is statistically significant, it is not huge
(this study found an increase from 0.5 per 1000 to
1.1 per 1000 for unexplained stillbirth at or after
39 weeks), so the odds are still overwhelmingly in
favor of a healthy baby. Still, something that should
be considered when weighing either elective c-section
or interventions that increase the risk of c-section.

I'm not sure that correlation and causation are correct here. If
C-sections
are performed for any reason other than "I want one", that implies that
there was a problem of some sort with the previous pregnancy. Since almost
any previous complication increases the risk of complications in the next
pregnancy, it is logical that women who have had a previous C-section
would
be at higher risk for pregnancy complications, and therefore pregnancy
loss,
including stillbirth.


But how do *you* define "problem of some sort"? Plenty of OBs seem to
define it as anything from "We think the baby might be big" to "It's been 24
hours and not enough progress" to maternal exhaustion caused largely by the
mother being denied food for a day or more while working very hard, to
genuine medical reasons like placenta previa, cord prolapse, and brow
presentation. Many of these 'problems' are not likely to repeat, like cord
prolapse. Do you believe this incidental occurrance increases the risk of a
complication in a future pregnancy? If not, which ones do?

--angela