Eran Hadar1, Nir Melamed, Keren Tzadikevitch-Geffen, Yariv Yogev. 1. Perinatal Division, Helen Schneider Hospital for Women, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah-Tiqva, 49100 Tel-Aviv, Israel.
Abstract
OBJECTIVE: To investigate the timing and risk factors of maternal complications of cesarean section (CS). METHODS: Review of the files of all women who underwent CS at a tertiary medical center between September 2007 and December 2008 yielded 100 patients with postpartum complications. Their clinical and surgery-related characteristics were compared with 100 women with uncomplicated CS operated in January 2009. Complications were analyzed by prevalence and time of occurrence. RESULTS: The only between-group difference in background factors was a higher rate of obesity (BMI > 30) in the controls. The complication rate was 5.7%. The most common complication was endomyometritis (3.6%), followed by wound infection (1.8%) and wound hematoma (1.2%). In most cases, endomyometritis was diagnosed on postoperative days 2-3 and wound complications on days 2-5; 7 of the 9 readmissions occurred on postoperative days 5-6. On multivariate analysis, significant independent predictors of postoperative complications were surgeon experience (OR = 2.4, 95% CI 1.2-4.8) and intra-partum CS (OR = 2.1, 95% CI 1.1-4.3). CONCLUSION: Cesarean section performed by a resident or during active labor is associated with an increased risk of postpartum complications. Medical teams should be alert to morbidity in women at risk, particularly during the first 4 days after CS.
OBJECTIVE: To investigate the timing and risk factors of maternal complications of cesarean section (CS). METHODS: Review of the files of all women who underwent CS at a tertiary medical center between September 2007 and December 2008 yielded 100 patients with postpartum complications. Their clinical and surgery-related characteristics were compared with 100 women with uncomplicated CS operated in January 2009. Complications were analyzed by prevalence and time of occurrence. RESULTS: The only between-group difference in background factors was a higher rate of obesity (BMI > 30) in the controls. The complication rate was 5.7%. The most common complication was endomyometritis (3.6%), followed by wound infection (1.8%) and wound hematoma (1.2%). In most cases, endomyometritis was diagnosed on postoperative days 2-3 and wound complications on days 2-5; 7 of the 9 readmissions occurred on postoperative days 5-6. On multivariate analysis, significant independent predictors of postoperative complications were surgeon experience (OR = 2.4, 95% CI 1.2-4.8) and intra-partum CS (OR = 2.1, 95% CI 1.1-4.3). CONCLUSION: Cesarean section performed by a resident or during active labor is associated with an increased risk of postpartum complications. Medical teams should be alert to morbidity in women at risk, particularly during the first 4 days after CS.
Authors: Katy L Townsend; Jen Akeroyd; Duncan S Russell; Jamie J Kruzic; Bria L Robertson; William Lear Journal: Adv Wound Care (New Rochelle) Date: 2018-06-01 Impact factor: 4.730
Authors: Paweł Jan Stanirowski; Anna Wnuk; Krzysztof Cendrowski; Włodzimierz Sawicki Journal: Arch Gynecol Obstet Date: 2015-04-12 Impact factor: 2.344