News

1st June 2004

Caesareans could be cut by a quarter

Researchers from Liverpool University and Liverpool Women's Hospital have suggested that up to one in four ceasarean sections could be avoided if women who were having difficult labours were treated differently.

They found that women whose wombs were not contracting properly had high levels of lactic acid, an indication of tired muscles. Treatments aimed at speeding up labour actually exacerbated the problem and the researchers suggest that not giving treatment would allow the womb to rest and regain strength for a natural labour.

About 21.5 per cent of UK births are done by caesarean section with almost a quarter of these occurring because the labour fails to progress.

The study was led by Professor Susan Wray of Liverpool University's Department of Physiology. Blood samples were taken from the wombs of 72 women who had undergone a caesarean section, two-thirds of which took place after medical assistance had failed to progress the labour.

The researchers found blood acidity levels were highest in women whose womb had failed to contract and for whom hormone therapy had not worked. They also had a higher level of lactic acid and a lower level of oxygen in their bloodstream.

The researchers say if muscles are working hard but not getting as much oxygen as they need, they change their biochemical make-up so they can still perform, which in turns produces lactic acid.

Currently, if a woman is having a slow or difficult labour she will be given an a synthetic type of oxytocin, the hormone which encourages the uterus to contract during labour. However, this can often fail, leading to a caesarean. The researchers at Liverpool suggest that this is because the muscles of the womb are too tired and cannot work any harder regardless of medical intervention.

They suggest that if women with high lactic acid levels could be identified, they would then not be given the treatment, and their bodies could be given time to recover.

Obstetrician Dr Siobhan Quenby, who worked on the study, said, "With further research, the team hopes to establish what factors contribute to lactic acid build-up in the first place, enabling mothers to enjoy a natural birth without surgery."

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