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Differences in outcomes between cesarean section in the second versus the first stages of labor
- Source :
- The journal of maternal-fetalneonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 32(15)
- Publication Year :
- 2018
-
Abstract
- We aimed to compare maternal morbidity and mortality of cesarean sections (CS) in the second versus first stage of labor.Retrospective study of all CS at a single, university-affiliated medical center, between January 2010 and December 2014. Eligibility was limited to term, singleton pregnancies with cephalic presentation. Maternal outcomes of second-stage CS were compared to those of first-stage CS. The primary outcome was defined as estimated blood loss1000 ml.Overall, 1004 women met the inclusion criteria, of which 290 (29%) had a second-stage CS and 714 (71%) had a first-stage CS. Women in the second-stage CS group had a higher nulliparity and hypertensive disorders rates and a lower rate of previous CS. Second-stage CS was associated with more than double the rate of estimated blood loss1000 ml (9.7% versus 3.8%, p.001), and more prone to unintentional uterine incision extension, uterine atony, hemoglobin decrease2 g/l and antibiotic treatment for suspected endometritis. In a multivariable logistic regression model, second-stage CS was found to be independently associated with unintentional uterine incision extension (OR 6.8, 95% CI 4.1-11.2), uterine atony (OR 3.3, 95% CI 1.4-8.0) and antibiotic treatment for suspected endometritis (OR 2.6, 95% CI 1.4-5.1), but not with excessive blood loss (OR 1.5, 95% CI 0.8-2.8). Additionally, failed assisted vaginal delivery prior to second-stage CS was not associated with a higher rate of complications.Second-stage CS is associated with higher rates of adverse maternal outcomes, mainly unintentional uterine incision extension, uterine atony, and suspected endometritis.
- Subjects :
- Adult
medicine.medical_specialty
Maternal morbidity
03 medical and health sciences
Young Adult
0302 clinical medicine
Primary outcome
Postoperative Complications
Blood loss
Labor Stage, Second
Pregnancy
Medicine
Humans
030212 general & internal medicine
Intraoperative Complications
Retrospective Studies
030219 obstetrics & reproductive medicine
business.industry
Singleton
Obstetrics
Cesarean Section
Cephalic presentation
Obstetrics and Gynecology
Retrospective cohort study
Pediatrics, Perinatology and Child Health
Female
business
Labor Stage, First
Subjects
Details
- ISSN :
- 14764954
- Volume :
- 32
- Issue :
- 15
- Database :
- OpenAIRE
- Journal :
- The journal of maternal-fetalneonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
- Accession number :
- edsair.doi.dedup.....a70008da84ddad48c454b6ef45330b72