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Cesarean delivery on maternal request in the United States from 1999 to 2015: a comment

      To the Editors:
      Community physicians are appreciative of the original research, which helps guide their daily practices. However, there are certain aspects of the maternal outcomes in this study that must be questioned.
      • Trahan M.J.
      • Czuzoj-Shulman N.
      • Abenhaim H.A.
      Cesarean delivery on maternal request in the United States from 1999 to 2015.
      One would assume that most cesarean deliveries on maternal request (CDMRs) would be performed on a scheduled, elective basis (most likely at 39 weeks of gestation) in the absence of ruptured membranes.
      ACOG Committee Opinion No. 761: cesarean delivery on maternal request.
      Therefore, the more than 6-fold increase in sepsis is not logical as chorioamnionitis is the most common precursor to sepsis in this setting.
      • Acosta C.D.
      • Kurinczuk J.J.
      • Lucas D.N.
      • et al.
      Severe maternal sepsis in the UK, 2011-2012: a national case-control study.
      In addition, as postpartum hemorrhage is almost 65% less likely in CDMRs, it does not follow that the transfusion rate is 3.5 times greater.
      • Trahan M.J.
      • Czuzoj-Shulman N.
      • Abenhaim H.A.
      Cesarean delivery on maternal request in the United States from 1999 to 2015.
      These inconsistencies bring into question the other statistics, perhaps because of the study’s retrospective nature.

      References

        • Trahan M.J.
        • Czuzoj-Shulman N.
        • Abenhaim H.A.
        Cesarean delivery on maternal request in the United States from 1999 to 2015.
        Am J Obstet Gynecol. 2022; 226: 411.e1-411.e8
      1. ACOG Committee Opinion No. 761: cesarean delivery on maternal request.
        Obstet Gynecol. 2019; 133: e73-e77
        • Acosta C.D.
        • Kurinczuk J.J.
        • Lucas D.N.
        • et al.
        Severe maternal sepsis in the UK, 2011-2012: a national case-control study.
        PLoS Med. 2014; 11e1001672

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