Broekers, Minouk Amber (2025) Determinants of the intrapartum cesarean delivery rate among nulliparous term singleton pregnancies with vertex presentation; a retrospective cohort study. thesis, Medicine.
Full text available on request.Abstract
Globally cesarean delivery (CD) rates are rising. Evaluating factors associated with intrapartum CD can give useful insight, especially in nulliparous women as they exert a major bearing on the CD rate. The association of induction of labor (IOL) with CD has a lot of discrepancies in previous literature. This study investigated maternal, fetal, and labor determinants of intrapartum CD, and examined the association between IOL and intrapartum CD. Method: This single-center retrospective cohort study analyzed nulliparous term singleton vertex (NTSV) pregnancies. We compared maternal, fetal, and labor characteristics between NTSV patients who delivered by intrapartum CD versus vaginal delivery (VD) and performed a binary logistic regression to identify CD determinants. The IOL protocol was modified during the study period by increasing the oxytocin dosage. Separate analyses were performed on patients who had labor induced with the new or old regime of oxytocin. Results: Among 1,518 NTSV patients, 251 (16.5%) underwent intrapartum CD and 1,267 (83.5%) delivered vaginally. Significant determinants of intrapartum CD included maternal age, prepregnancy BMI, birthweight, gestational age, fetal head position, epidural analgesia use, and labor onset. Separate analysis of 523 induced NTSV patients showed that an increased dosage of oxytocin reduced intrapartum CD rates, but not significantly. Conclusion: Our research gives insight into determinants of intrapartum CD which can be used for more personalized and informed decision-making during labor, as well as patient counselling practices. Additionally, our findings show that increasing oxytocin dosage for IOL did not significantly reduce CD rates, but future research is needed with larger patient populations.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Zwart, dr. J.J. and Kamphorst, dr. K. |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Feb 2026 14:22 |
| Last Modified: | 06 Feb 2026 14:22 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3888 |
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