Comparison of obstetrical interventions in women with vaginal and cesarean section delivered: cross-sectional study in a reference tertiary center in the Northeast of Brazil

Objective: To compare the performance of obstetrical interventions and maternal and perinatal outcomes between vaginal and cesarean delivery routes in pregnant women at normal risk. Type of article: Original article. Desing: Cross-sectional study with 421 participants admitted for spontaneous or induced labor with full-term singleton gestations and fetuses weighing between 2,500 and 4,499 g. Setting: Maternal Fetal-Medicine Service, Assis Chateaubriand Maternity. Federal University of Ceara (UFC), Fortaleza-CE, Brazil. Methods: The instrument of data collection was divided into socio-demographic, clinical, and obstetric characteristics: data of labor and delivery: maternal morbidity; maternal outcome and perinatal outcomes. Pearson's chi-square test and Fisher's exact test were used to verify associations between the groups. Results: The mean age was 22.8 +/- 6.0 (vaginal) and 22.9 +/- 4.9 (cesarean section). Overall, 44.5% of vaginal deliveries and 85.5% of cesarean sections were monitored electronically (p < 0.001). Immediate skin-to-skin contact (84.1%) and first-hour breastfeeding (80.4%) were more frequent in vaginal deliveries compared with cesarean deliveries (27% vs. 61.0%, p < 0.001). The prevalence of puerperal infections was 1.2% (vaginal) and 5.0% (cesarean section) with a p value of 0.02; 40% of cesarean-delivered newborns and 9.7% of vaginally-delivered newborns were referred to the neonatal intensive care unit (p < 0.001). Conclusion: The cesarean section was associated with a lower frequency of useful practices, a higher frequency of harmful practices, worse neonatal outcomes, and a higher rate of postpartum infections.