TY - JOUR
T1 - Timing and risk factors of maternal complications of cesarean section
AU - Hadar, Eran
AU - Melamed, Nir
AU - Tzadikevitch-Geffen, Keren
AU - Yogev, Yariv
PY - 2011/4
Y1 - 2011/4
N2 - 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.
AB - 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.
KW - Cesarean section
KW - Complications
KW - Maternal
KW - Risk factors
KW - Timing
UR - http://www.scopus.com/inward/record.url?scp=79955931130&partnerID=8YFLogxK
U2 - 10.1007/s00404-010-1450-0
DO - 10.1007/s00404-010-1450-0
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C2 - 20354706
AN - SCOPUS:79955931130
SN - 0932-0067
VL - 283
SP - 735
EP - 741
JO - Archives of Gynecology and Obstetrics
JF - Archives of Gynecology and Obstetrics
IS - 4
ER -