Maternal Mortality and Severe Morbidity Associated With Low-Risk Planned Cesarean Delivery Versus Planned Vaginal Delivery at Term
Why this work is in the frame
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Bibliographic record
Abstract
Reported rates of elective primary cesarean delivery continue to increase markedly, prompting the present study comparing the risks of elective cesarean delivery with those of planned vaginal delivery. Participating were 46,766 healthy women at term who underwent planned cesarean delivery because of breech presentation, and 2,292,420 others having planned vaginal delivery. Overall rates of severe maternal morbidity were 27.3 per 1000 deliveries in the planned cesarean group and 9.0 per 1000 with planned vaginal delivery. Women in the planned cesarean group had increased postpartum risks of cardiac arrest, wound hematoma, hysterectomy, major puerperal infection, complications of anesthesia, venous thromboembolism, and hemorrhage necessitating hysterectomy. In addition, these women remained in hospital longer than those having planned vaginal delivery, but they had a lower risk of hemorrhage requiring blood transfusion. Absolute risk increases were low. There was no significant group difference in rates of in-hospital maternal death, and no mother died in hospital following planned cesarean delivery. Women having either spontaneous or instrumental vaginal delivery were less likely to become very ill or die than those having emergency cesarean delivery. The latter women had the highest in-hospital mortality rate (9.7 per 1000 deliveries) and also the highest rates of maternal morbidity—particularly from cardiac arrest, uterine rupture, hemorrhage requiring hysterectomy, hemorrhage requiring transfusion, and obstetrical shock. Women considering elective cesarean delivery should be aware that the risk of severe maternal morbidity is higher than with planned vaginal delivery. At the same time, absolute differences in morbidity risk were not marked in this study.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it