(659) Timing of delivery of third cesarean delivery

The study included624  CDs, of which 199 were performed at 37+0 to 37+6 weeks, 381 were at 38+0-38+6 weeks and 44 were at > 39 weeks of gestation at the time of delivery. Initial univariate analysis is presented in tables 1,2. In a multivariate analyses, both study groups were associated with significantly higher rates of emergent CDs, after adjusting for maternal age, parity and ethnicity.  The adjusted ORs at 37+0-37+6 weeks and at > 39 weeks of gestation were 4.55 (p < 0.001) and 10.93 (p < 0.001), respectively. In multivariate analysis after adjusting also for emergent CDs, CDs at 37+0-37+6 weeks of gestation was significantly associated with maternal and neonatal length stay > 4 days OR 1.97 (p=0.006) and 1.74 (p=0.024), respectively. CD at 37+0-37+6 weeks was also associated with composite of adverse neonatal outcome, aOR 1.73 P=0.016.


Conclusion:

Our study demonstrated that our institutional policy regarding scheduling third CD at 38+0 to 38+6 weeks associated with reduced risk for emergent CD and beneficial maternal and neonatal outcomes.