Evidence map›Paper›PMID 33392930›Full record

ArticleMaternal and child health journal2021

Feasibility of Conducting a Trial Assessing Benefits and Risks of Planned Caesarean Section Versus Planned Vaginal Birth: A Cross-Sectional Study.

Melissa M Amyx, Fernando Althabe, Julie Rivo, Verónica Pingray, Nicole Minckas, María Belizán, Luz Gibbons, Gerardo T Murga, Ángel E Fiorillo, Julio D Malamud and 4 more

Abstract read
In one paragraph

Article in Maternal and child health journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Informing Decision-Making About Caesarean Birth: A Delphi Study to Develop a Core Information Set.BJOG : an international journal of obstetrics and gynaecology · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Melissa M AmyxSchool of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., #2400, New Orleans, LA, 70112, USA. mamyx@tulane.edu.ORCID http://orcid.org/0000-0003-4660-7716
Fernando AlthabeMother and Child's Health Research Department, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Dr. Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina.
Julie RivoDuke University School of Medicine, Duke University, 8 Duke University Medical Center Greenspace, Durham, NC, 27703, USA.
Verónica PingrayMother and Child's Health Research Department, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Dr. Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina.
Nicole MinckasMother and Child's Health Research Department, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Dr. Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina.
María BelizánMother and Child's Health Research Department, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Dr. Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina.
Luz GibbonsMother and Child's Health Research Department, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Dr. Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina.
Gerardo T MurgaInstituto de Maternidad Y Ginecología Nuestra Señora de Las Mercedes, Av. Mate de Luna 1535, 4000, San Miguel de Tucumán, Tucumán Province, Argentina.
Ángel E FiorilloCentro de Educación Médica E Investigaciones Clínicas "Norberto Quirno" (CEMIC), Av. E. Galván 4102, C1431FWO, Buenos Aires, Argentina.
Julio D MalamudSanatorio de La Mujer, San Luis 2493, S2002, Rosario, Santa Fe, Argentina.
Roberto A CasaleHospital Nacional A. Posadas, El Palomar, Buenos Aires, Argentina.
Gabriela CormickMother and Child's Health Research Department, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Dr. Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina.
José M BelizánMother and Child's Health Research Department, Institute for Clinical Effectiveness and Health Policy (IECS-CONICET), Dr. Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina.
Feasibility of “Mode of Delivery Trial” Study Group

Funding

Fogarty Global Health Fellows Coordinating CenterR25TW009340 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI CHI, BENJAMIN H. · 2012 to 2016
$6.9M
Training in Global Reproductive Epidemiology (TIGRE)T32HD057780 · NICHD · TULANE UNIVERSITY OF LOUISIANA · PI BUEKENS, PIERRE · 2009 to 2013
$801k
FIC NIH HHS R25 TW009340FIC NIH HHS R25TW009340Maternal and Child Health Bureau T03MC07649NICHD NIH HHS T32 HD057780NIH HHS 5T32HD057780
6 · The paper itself

Abstract

introductionThough interest is growing for trials comparing planned delivery mode (vaginal delivery [VD]; cesarean section [CS]) in low-risk nulliparous women, appropriate study design is unclear. Our objective was to assess feasibility of three designs (preference trial [PCT], randomized controlled trial [RCT], partially randomized patient preference trial [PRPPT]) for a trial comparing planned delivery mode in low-risk women.

methodsA cross-sectional survey of low-risk, nulliparous pregnant women (N = 416) and healthcare providers (N = 168) providing prenatal care and/or labor/delivery services was conducted in Argentina (2 public, 2 private hospitals). Proportion of pregnant women and providers willing to participate in each design and reasons for not participating were determined.

resultsFew women (< 15%) or professionals (33.3%) would participate in an RCT, though more would participate in PCTs (88% women; 65.9% professionals) or PRPPTs (44.4% public, 63.4% private sector women; 44.0% professionals). However, most women would choose vaginal delivery in the PCT and PRPPT (> 85%). Believing randomization unacceptable (RCT, PRPPT) and desiring choice of delivery mode (RCT) were women's reasons for not participating. For providers, commonly cited reasons for not participating included unacceptability of performing CS without medical indication, difficulty obtaining informed consent, discomfort enrolling patients (all designs), and violating women's right to choose (RCT). CONCLUSIONS FOR PRACTICE: Important limitations were found for each trial design evaluated. The necessity of stronger evidence regarding delivery mode in low-risk women suggests consideration of additional designs, such as a rigorously designed cohort study or an RCT within an obstetric population with equivocal CS indications.

Indexed as

Elective Surgical ProceduresPatient PreferenceAdolescentAdultArgentinaCesarean SectionCohort StudiesCross-Sectional StudiesDelivery, ObstetricFeasibility StudiesFemaleHealth PersonnelHumansMiddle AgedPregnancyRisk AssessmentElective cesarean deliveryPartially randomized patient preference trialPreference controlled trialRandomized controlled trialVaginal delivery

Identifiers

PMID33392930
PMCPMC7922524

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.