Cesarean deliveries during labor linked to risks in future pregnancies

Published

12 months ago

December 16, 2024

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By Priyanjana Pramanik, MSc. Reviewed by Danielle Ellis, B.Sc. Dec 16 2024

Researchers suggest an association between cesarean sections during labor and recurrent preterm birth or mid-trimester loss in subsequent pregnancies, potentially due to cervical damage Study: Cervical cesarean damage as a growing clinical problem: The association between in-labour cesarean section and recurrent preterm birth in subsequent pregnancies. Image Credit: Oksana Shufrych/Shutterstock.com

In a recent perspective published in PLOS Medicine, researchers discussed the implications of cesarean section (C-section) deliveries during labor for preterm births in subsequent pregnancies. Rising rates of C-sections

C-section rates have risen steadily worldwide over the past decades. From 1990 to 2014, the global C-section rate rose by 12.4%. In England, the prevalence is even higher, with over one-third of women delivering by C-section.

Of these, approximately 24% are emergency procedures, and 5% take place when the cervix is fully dilated. In North America, full dilatation C-section rates have surged by 44% over the last decade.

Several factors contribute to this trend, including shifts in clinical and professional training practices, fears related to litigation, and evolving cultural and social expectations. While C-sections can be life-saving during pregnancy complications, their rising use, particularly in emergency settings, raises concerns about their long-term implications for maternal and fetal health. Future implications for pregnancies

Emergency procedures, especially those late in labor, have been linked to adverse outcomes in future pregnancies. Observational studies suggest a strong association between in-labor C-sections and increased risks of spontaneous preterm birth (sPTB) and mid-trimester pregnancy loss.

The risks are especially pronounced if cervix dilation is greater at the time of surgery, peaking when full dilation has taken place. For the majority of women who undergo an in-labor C-section, preterm birth risk in a future pregnancy remains low (less than 5%). However, women who experience preterm birth after an in-labor C-section are likelier to face recurrent preterm births in subsequent pregnancies.

In a recent analysis, researchers found that women who had an in-labor C-section and later experienced a preterm birth had a 2.7-fold higher risk of recurring sPTB than women with other preterm birth risk factors. When considering mid-trimester losses, the relative risk increased to 5.65. In this cohort, 54% of women who experienced preterm birth following an in-labor C-section went on to have a subsequent preterm delivery, a rate significantly higher than for other high-risk groups. Cervical damage is a key factor

The observed association between in-labor C-sections, sPTB, and mid-trimester loss may be explained by cervical damage during surgery. The cervix plays a central role in preventing premature labor. Surgical interventions during advanced labor stages often involve incisions close to or within cervical tissue, increasing the likelihood of trauma.

As labor progresses, the head of the fetus descends into the pelvis, making surgical delivery more challenging. This can result in a greater risk of cervical injury due to surgical extensions, sutures, or infection, compromising cervical integrity. Related StoriesAI-generated handoff notes: Study assesses safety and accuracy in emergency medicineNew insights into anti-seizure medications during pregnancyStudy identifies potential epigenetic biomarker for preeclampsia

Advanced imaging techniques, such as transvaginal ultrasound (TVUS), provide further insights into the role of cervical damage. Cesarean scars are often visible as disruptions in the uterine wall. Conventional interventions and alternative approaches

Standard interventions for preventing sPTB, such as transvaginal cerclage (TVC), are less effective among women with prior in-labor C-sections. In TVC, a suture is placed in the cervix during early pregnancy to reduce the risk of preterm labor. However, in women with previous in-labor C-sections, TVC failure rates are high.

A study found that these women were 10 times likelier to deliver before 30 weeks gestation than women with other risk factors. In the same analysis, 46% of the women with prior in-labor C-sections and TVC experienced either sPTB or mid-trimester loss.

For women with cervical damage from in-labor C-sections, transabdominal cerclage (TAC) may be an effective alternative. TAC bypasses damaged cervical tissue, offering better protection than TVC.

A retrospective cohort study found that TAC significantly reduced sPTB rates before 30 weeks compared to TVC (odds ratio 0.09). This suggests that TAC could be a valuable option for women with a history of in-labor C-sections, particularly those with recurrent preterm births. Conclusion

C-sections are the most common surgical procedure worldwide, impacting nearly one-quarter of women. The potential for cervical damage during in-labor C-sections and its implications for future pregnancies underscores the need for tailored management strategies. Clinicians and patients must recognize these risks and work together in shared decision-making to ensure better maternal and fetal outcomes.

The link between in-labor C-sections, mid-trimester losses, and sPTB highlights an emerging clinical problem. With the increasing prevalence of in-labor C-sections, there is an urgent need to address this issue through improved training in instrumental delivery and labor management. Further investigation is also needed to understand better the mechanisms driving cervical damage and to develop strategies for minimizing harm.

Improved imaging protocols could play a crucial role in identifying at-risk women and guiding treatment decisions. Additionally, evaluating the effectiveness of interventions, such as TAC, in preventing adverse outcomes could inform future clinical guidelines. Journal reference: Cervical cesarean damage as a growing clinical problem: The association between in-labour cesarean section and recurrent preterm birth in subsequent pregnancies. Van der Krogt, L., Shennan, A. PLOS Medicine (2024). doi: 10.1371/journal.pmed.1004497
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004497

Entertainment

US director and actor Rob Reiner and wife found dead ‘with stab wounds’ at their LA home

Published

5 hours ago

December 15, 2025

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US director and actor Rob Reiner and wife found dead 'with stab wounds' at their LA home

US director and actor Rob Reiner and his wife have been found dead at their home in Los Angeles.

Reiner and wife Michele Singer Reiner apparently died of stab wounds and a family member is being questioned, US media reported.

The Los Angeles Fire Department said a 78-year-old man and a 68-year-old woman were found dead inside a property, without identifying the victims. Reiner turned 78 in March.

Detectives from the LAPD Robbery Homicide Division have been assigned to the case, the force said in a statement.

LAPD Captain Mike Bland said they were investigating an “apparent homicide”.

A large police presence gathered at the house.

‘Celebrated director’

Reiner was a celebrated director whose work included some of the most memorable movies of the 1980s and ’90s.

He directed such classics as This Is Spinal Tap, The Princess Bride, When Harry Met Sally, A Few Good Men and Stand By Me.

He also acted, starring in Sleepless in Seattle and The Wolf of Wall Street among others. His most recent high-profile work was a recurring guest role in the hit show The Bear.

He met Michele Singer in 1989, while directing When Harry Met Sally. They have three children together.

Michele used to work as a photographer and took the photo of Donald Trump that appears on the cover of his book Trump: The Art Of The Deal.

A spokesperson for the Reiner family said: “It is with profound sorrow that we announce the tragic passing of Michele and Rob Reiner. We are heartbroken by this sudden loss, and we ask for privacy during this unbelievably difficult time.”

Los Angeles mayor Karen Bass said Reiner’s death was a devastating loss for the city.

“Rob Reiner’s contributions reverberate throughout American culture and society, and he has improved countless lives through his creative work and advocacy fighting for social and economic justice,” she said.

“An acclaimed actor, director, producer, writer, and engaged political activist, he always used his gifts in service of others.”

Hollywood mourns a legend

A group of two dozen journalists are gathered behind a police cordon at the end of a street in Brentwood, usually a quiet and secure suburb of LA, an enclave of multimillionaires.

Beyond the yellow tape is the home of acclaimed Hollywood film director Rob Reiner and his wife Michele.

Stationed outside the house is a trailer being used by a forensic team gathering evidence from inside. The bodies of Rob and Michele were found with apparent stab wounds.

Every so often, local people wander past the house, expressing shock at what has happened. In this part of LA, home to many in show business, Rob Reiner is incredibly well-regarded. Even if you don’t immediately recognise his face, you know his work.

He is the director behind iconic films like The Princess Bride and Stand By Me. But it was while filming When Harry Met Sally, one of the most iconic rom coms of all time, that Rob met Michele, a photographer.

Their relationship persuaded him to change the ending of the film to ensure the main characters, played by Meg Ryan and Billy Crystal, ended up together.

‘Creative, funny, and beloved’

Reiner was a champion of liberal causes and a political activist.

In the 2004 presidential election, he backed Democratic candidate John Kerry and featured in advertisements taking aim at incumbent President George W Bush.

Reiner also supported Democratic presidential hopefuls Al Gore and Hillary Clinton.

Former US president Barack Obama has led the tributes. He wrote on X that “Michelle and I are heartbroken by the tragic passing of Rob Reiner and his beloved wife, Michele. Rob’s achievements in film and television gave us some of our most cherished stories on screen.”

Former House speaker Nancy Pelosi said: “It’s hard to think of anyone more remarkable and excellent in every field and endeavour they pursued.

“Rob was creative, funny, and beloved. And in all of their endeavours, Michelle was his indispensable partner, intellectual resource, and loving wife.

“Personally, Rob cared deeply about people and demonstrated that in his civic activities – whether by supporting the First 5 initiative or fighting against Prop 8 in California.

“Civically, he was a champion for the First Amendment and the creative rights of artists. And professionally, he was an iconic figure in film who made us laugh, cry and think with the movies he created.”

Actress Kathy Bates, who starred in Reiner’s film Misery, told NBC News: “I’m horrified hearing this terrible news. Absolutely devastated. I loved Rob.

“He was brilliant and kind, a man who made films of every genre to challenge himself as an artist. He also fought courageously for his political beliefs.

“He changed the course of my life. Michele was a gifted photographer. She shot my beautiful photos for the Misery campaign. My heart breaks for them both. My thoughts are with their family.”

Environment

Peugeot’s classic 103 moped gets ready for an electric return

Published

5 hours ago

December 15, 2025

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Peugeot's classic 103 moped gets ready for an electric return

Peugeot is officially bringing back one of its most iconic two-wheelers – the Peugeot 103 – this time as a modern electric moped.

For anyone who grew up in the heyday of European mopeds, the 103 name carries serious nostalgia. First launched in 1971, the original gasoline-powered Peugeot 103 became one of the most popular mopeds of all time thanks to its simple design, low cost, and accessibility for young riders who didn’t need a full motorcycle license.

You wouldn’t have to look far to find many people arguing that it is one of the most iconic mopeds ever produced, earning a legendary status in Europe thanks to its simplicity, reliability, and affordability.

Produced in massive numbers for decades, with countless variants and special editions, the 103 was especially popular in France, where it became deeply embedded in everyday culture, from city streets to rural towns. Its mechanical simplicity also made it a favorite for customization and tuning, helping cement its reputation not just as transportation, but as a rite of passage for generations of riders. Now, more than 50 years later, Peugeot is betting that the same formula can work again in the electric era.

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Classic versus modern take on the Peugeot 103 moped (left image via Reddit)

The new electric Peugeot 103 is expected to be a lightweight, urban-focused machine aimed squarely at city riders. Rather than trying to compete with high-performance electric motorcycles, Peugeot appears to be leaning into the original 103’s strengths: practicality, ease of use, and everyday transportation. Early information suggests removable battery options of either 1.6 or 2.2 kWh, which would be consistent with most small-format electric mopeds having batteries in this range, offering a modest but usable range for commuting and short trips while still being light enough to carry for off-board charging.

Styling-wise, Peugeot is clearly leaning into retro appeal. The electric 103 takes visual cues from the original model while incorporating modern touches like LED lighting and updated electronics. Under the skin, it’s expected to share technology with Peugeot’s SPx electric concept, giving it a contemporary electric drivetrain while keeping the overall package simple.

There don’t appear to be any visible pedals, meaning this could be more of a noped than a moped, but that would also keep it in line with several other lightweight electric two-wheelers in this modern class of electric commuters.

Electrek’s Take

The revival of the 103 feels like a smart move, especially since light electric motorbikes are some of the easiest to produce and sell right now. As cities continue to restrict cars and push for cleaner transportation, lightweight electric mopeds are becoming increasingly relevant. By reviving a beloved nameplate, Peugeot is tapping into decades of cultural memory, while offering a clean, quiet, and approachable way to navigate modern cities that could appeal to younger riders, even without the historic draw.

via: Visordown

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Technology

CNBC Daily Open: U.S. stocks retreat from highs as Broadcom leads tech sell-off

Published

6 hours ago

December 15, 2025

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CNBC Daily Open: U.S. stocks retreat from highs as Broadcom leads tech sell-off

Signage at the Broadcom Inc. headquarters in San Jose, California, U.S., on Monday, June 2, 2025.

David Paul Morris | Bloomberg | Getty Images

The sell-off in artificial intelligence stocks continued unabated Friday stateside. Broadcom shares tumbled more than 11% as investors grew concerned over lower margins and uncertain deals. Names such as Nvidia, Advanced Micro Devices and Oracle fell in sympathy, which caused major U.S. indexes to close lower.

It was a motif patterning the week. Even though the Dow Jones Industrial Average rose 1.1% week on week on the back of outperformance by financial stocks, tech names dragged down the S&P 500 and the Nasdaq Composite, which fell 0.6% and 1.6% respectively for the week.

That said, investors could have just been jittery amid the narrative of an apparent AI bubble, and were spooked by any sign of bad news. After all, Broadcom’s earnings — as well as its guidance for the current quarter — breezed past expectations.

“Frankly we aren’t sure what else one could desire as the company’s AI story continues to not only overdeliver but is doing it at an accelerating rate,” Bernstein analyst Stacy Rasgon, who has a “buy” rating on Broadcom, wrote in a Friday note.

Future prospects also look rosy, according to UBS. “We expect high profitability and the accelerating impact of the AI, power and resources, and longevity themes to drive 2026 performance,” said strategist Sagar Khandelwal.

But in the near term, investors may still be flighty, unless something concretely reassuring, such as Oracle achieving positive cash flow, reassures them the snapping sound is just a twig in the forest.

What you need to know today

U.S. stocks dragged down by AI names. Major indexes fell Friday, a day after they hit record highs. Asia-Pacific markets traded lower Monday. South Korea’s Kospi retreated roughly 1.5% as of 2:45 p.m. Singapore time (1:45 a.m. ET), leading losses in the region.

China’s economic slowdown deepens. Even though the country’s retail sales and industrial production grew year on year in November, their increase missed forecasts and slowed from the previous month. Investment in fixed assets in the January-to-November period contracted from a year earlier.

The end of the ‘Berkshire way’? Several aspects of Berkshire Hathaway’s leadership transition are signaling that the conglomerate is drifting away from the famously decentralized “Berkshire way,” CNBC’s Alex Crippen writes.

Hong Kong court finds Jimmy Lai guilty. The 78-year-old pro-democracy activist and media baron was ruled guilty of sedition and collusion with foreign countries by a Hong Kong court on Monday. The results might unsettle foreign investors, analysts say.

[PRO] China’s food security strategy. The spat between Beijing and Washington over soybean purchases has highlighted the evolution of China’s domestic agriculture industry. Goldman Sachs thinks this is the best way to play the sector.

And finally…

Copper prices have soared this year, hitting multiple record highs, fueled by supply disruptions and fears over U.S. tariffs.

Imagebroker/sunny Celeste | Imagebroker | Getty Images

Copper could hit ‘stratospheric new highs’ as hoarding of the metal in U.S. continues

Copper prices have hit multiple record highs this year, fueled by supply disruptions and as fears over U.S. tariffs have led to a surge in demand. The rally is set to continue into 2026.

Citi analysts expect prices of the red metal to skyrocket on the back of stronger demand led by the energy transition and artificial intelligence sectors. Electrification, grid expansion and data-center build-outs require large amounts of the metal for wiring, power transmission and cooling infrastructure.

— Lee Ying Shan