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Objective: To explore patient attitudes related to cesarean delivery on maternal request (CDMR)., Study Design: Questionnaires were distributed to patients in mid-trimester. Questions assessed patient demographics, knowledge, perceived risks, and attitudes about CDMR., Results: Three hundred and fourteen questionnaires and 188 written responses were used for analysis. Most patients (95%) did not believe that CDMR was advisable and felt that vaginal delivery (VD) was safer for both mother (93%) and baby (88%). Of patients who did not believe CDMR was advisable, the most common explanations were classified into categories of "normal is better," "risk of complications" (67%), only 1% of this group felt that the decision should be left up to the individual. Of the remaining patients (5%) who supported CDMR, 75% believed that the decision should be left up to the individual., Conclusion: The majority of women in our population do not think that CDMR is advisable.

Objective To describe labor and delivery outcomes in pregnant patients presenting to the hospital setting with an acute severe migraine headache attack earlier in the same gestation. Methods We retrospectively reviewed pregnancy and delivery records from a database of consecutive inpatient neurology consultations for acute headache in pregnant women over a 5 year period. Results We identified 86 pregnant women with acute migraine. The mean age was 29.3 (±6.4) years. Nearly half had migraine with aura (35/86 [40.7%]), 12.8% (12/86) had chronic migraine, and 31.4% (27/86) presented in status migrainosus. Complication rates included 54.7%([41/75], 95% CI 29.87, 52.13) for at least one adverse outcome, 28.0% ([21/75], 95% CI 11.78, 30.22) for preterm delivery, 21.3% ([16/75], 95% CI 7.7, 24.3) for preeclampsia, 30.6% ([23/75] 95% CI 13.48, 32.52) for cesarean delivery, and 18.7% ([14/75] 95% CI 6.15, 21.85) for low birthweight. Conclusions Pregnant women seeking treatment for acute migraine headache experienced a higher rate of preterm delivery, preeclampsia, and low birthweight but a lower rate of cesarean delivery than the local and general populations. More than half (54.7% [41/75] 95% CI 29.87, 52.13) of the study patients experienced some type of adverse birth outcome, suggesting that pregnancies in migraine patients presenting to an acute care setting may benefit from more intense surveillance. [ABSTRACT FROM AUTHOR]