Risk factors associated with accidental fetal skin lacerations during cesarean delivery

Lior Har-Shai, Rita Kreichman, Reuven Kedar, Micky Osovsky, Rony Chen, Idit Lavi, Issa Metanes, Miriam Segal, Sar El Ofek, Samar Mattar, Samer Hassan, Aviv Kramer, Leonid Bryzgalin, Dean Ad-El, Lena Sagi-Dain, Ofer Lavie, Yaron Har-Shai*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: To identify risk factors associated with accidental fetal skin lacerations (AFL) during cesarean section (CS). Methods: This retrospective cohort study was obtained from the registry of two large medical centers between 2014 and 2019. The study group comprised all newborns identified with AFL. The rates of various potential risk factors were compared between the study group and a group of CS at which no AFL had occurred (the control group). Results: Of the 14 666 CS deliveries, 48 cases of AFL (0.33%) were documented, 52% of these following urgent CS. Compared with the control group (n = 14 618), the only risk factors associated with AFL were premature rupture of membranes (PROM) (odds ratio [OR] 5.38, 95% convidence interval [CI] 2.97–9.74) and meconium-stained amniotic fluid (OR 6.50, 95% CI 2.55–16.54). In subgroup analysis by CS urgency, no significance for these factors was noted in elective CS group; but higher rates of both PROM and meconium-stained amniotic fluid were noted in the AFL during urgent CS (OR 14.23, 95% CI 6.30–32.16 and OR 15.36, (95% CI 5.65–41.75, respectively). Conclusions: During urgent CS, the surgeon should bear in mind that the presence of PROM or meconium-stained amniotic fluid should prompt extra care and application of preventive measures to decrease the rates of AFL.

Original languageEnglish
Pages (from-to)131-135
Number of pages5
JournalInternational Journal of Gynecology and Obstetrics
Issue number1
StatePublished - Jan 2023
Externally publishedYes


  • accidental fetal skin lacerations
  • cesarean section
  • meconium
  • premature rupture of membranes
  • risk factors


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