In maternity care, the outcomes of two patients must be considered. Table 4 demonstrates the results of the meta-analysis relating TOL as compared with ERCS for infant outcomes for which there was usable data. The literature on outcome data for infants delivered to mothers following previous cesarean section was reviewed. No study evaluated the long term effects of the two delivery options on the infant beyond discharge from the hospital. While Apgar scores do not predict ultimate infant outcome, they may suggest the presence of intrapartum fetal distress and they were the only fetal outcomes found in the literature besides infant mortality.
Selection bias can be a problem when comparing outcomes.
Table 5 shows that oxytocin use did not impact significantly on Apgar scores or death rates. Most studies suggested that pregnant women with a prior cesarean section generally received early, closely monitored prenatal care. The contribution of such care to an infant mortality rate that was lower than that found in the general population is unknown. ERCS delivery was not significantly different. Many times physicians in clinical practice are faced with an array of methods and approaches for patient care.