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Appendix 4.1: Included items dealing with clinical interventions and maternal mortality
Author
(year)
(IV)/(EV)
Target population Brief intervention description Targeted
outcome(s)
Surgical/instrumental procedures
Agarwal
(2007a)
(+)/(++)
Malhotra
(1994)
(+)/(-)
Women with post-
Caesarean
pregnancy
Women with
preterm breech
delivery
Comparison of CS and vaginal birth after
Caesarean (VBAC).
CS: The general policy of this hospital does
not favour routine use of CS for a preterm
breech foetus. Before 33 completed weeks
of gestation, CS is occasionally performed
for foetal indication unless associated with
adverse obstetric factors. The indications
for CS for a preterm breech after 33 weeks
are the same as for a singleton term breech
foetus. All the CS and a majority of the
vaginal deliveries were attended by a
paediatrician who assessed the newborn for
gestational age, congenital abnormality and
birth injury, and assigned the Apgar score.
Neonatal
mortality
Perinatal
mortality
Stillbirth
Combined
intrapartum
and neonatal
deaths
Findings summary
Appendix 4.1
VBAC is associated with higher perinatal
mortality and maternal morbidity.
Although the combined intrapartum and
neonatal mortality was significantly
higher for vaginal delivery (35.9% vs
17.7%), there was no significant
difference when the data was
correlated with birthweight or
gestational age.
What are the effects of different models of delivery for improving maternal and infant health outcomes for poor people in urban areas in low income
and lower middle income countries?
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