Comparisons of the morbidity outcomes in repeated cesarean sections using midline and <scp>P</scp>fannenstiel incisions

Puttanavijarn, Lunthaporn; Phupong, Vorapong

doi:10.1111/jog.12112

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…Our analysis for types of incision data showed that the Pfannenstiel incision was used in the vast majority of the cases for both the study group (97.2%) and the controls (99.0%). No statistically significant difference was found between the groups regarding types of incision, similar to the observation of the cohort study conducted at the King Chulalongkorn Memorial Hospital, Bangkok, Thailand (7). In addition, we found a significant difference in the type of anesthesia that had been used between our study group and the control group.…”

Section: Discussionsupporting

confidence: 83%

“…According to the American Center for Disease Control and Prevention, the cesarean delivery rate was 20.7% in 1995 in the United States (US) which substantiality increased to 31.9% in 2016 (6). In addition, there was a study conducted at the King Chulalongkorn Memorial Hospital, Thailand showing that the number of CSs performed has dramatically increased in several countries over the past ten years, they reported that the CS rate has increased from 34.4% in 2003 to 46.5% in 2011 (7). According to the Turkish Demographic and Health Survey, the CS rate in 1993 was 8% and later increased to 37% in 2008, as reported by other studies (8).…”

Section: Introductionmentioning

confidence: 99%

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Outcomes and Complications After Repeat Cesarean Sections Among King Abdulaziz University Hospital Patients

Alshehri¹,

Ammar²,

Aldhubabian³

et al. 2019

Mater Sociomed

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Introduction: Cesarean section (CS) is a surgical procedure that often saves the lives of both the mother and the baby, while a previous CS is one of the main indications for cesarean delivery in current pregnancy. Aim: Our aim was to determine the surgical and obstetrical outcomes and complication for the mother and the neonate after 4 or more CSs and compare it with mothers who had less than 4 previous CSs. Methods: This case-control study was conducted by reviewing the records of all women who underwent multiple CSs from 2013 to 2018. Our study group comprised of 394 women who had 4 or more CSs, and our control group comprised of similar number of women who had previous history of two or three CSs. Results: A total of 788 patients were enrolled in our study. We found that adhesions were the most common complications in our study group with a considerable increase in number of both moderate and severe adhesions in the study group compared to the controls with p-value of <0.001. Conclusion: Increasing number of CSs leads to an increase of the complications risk. Among the complications, adhesions were the most common in our study group, followed by intraoperative bleeding.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Outcomes and Complications After Repeat Cesarean Sections Among King Abdulaziz University Hospital Patients

Alshehri¹,

Ammar²,

Aldhubabian³

et al. 2019

Mater Sociomed

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“…Makoha et al found that in the presence of one or more prior CD, a vertical skin incision was associated with a higher odds of bladder injury (OR 3.89, 95% CI 1.4-8.9) [6]. However, other studies have not supported this finding or discerned other differences in outcomes based on the type of skin incision [9,10].…”

Section: Commentmentioning

confidence: 81%

“…A MEDLINE search for publications in English between January 1, 1980 and November 30, 2014, using the keywords ''repeat cesarean delivery'', ''higher-order cesarean delivery'', ''multiple cesarean section'' or ''multiple cesarean delivery'', and ''skin incision'' or ''skin incision type'' or ''abdominal skin incision'', yielded only three studies specifically concerned with the type of skin incision and obstetric morbidity [6,9,10] with one study being limited to emergent CDs [9], and two studies including both primary and repeat CDs [6,10]. Correspondingly, the skin incision type that minimizes operative morbidity for women who are having a CD after multiple prior CDs is uncertain.…”

mentioning

confidence: 99%

The association of skin-incision type at cesarean with maternal and neonatal morbidity for women with multiple prior cesarean deliveries

Palatnik

Grobman

2015

European Journal of Obstetrics & Gynecology and Reproductiv

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“…3,23 In general, a vertical skin incision is thought to have higher rates of postoperative complications, although recent studies have challenged this idea. [24][25][26][27] In an effort to routinely employ a transverse suprapubic skin incision, it has become routine in our institution to retract the pannus in a rostral direction using adhesive tape placed after induction of anesthesia and before surgical preparation of the skin. However, it can be argued that such cephalad retraction of the pannus might promote subclinical hypoventilation due to resultant changes in diaphragmatic excursion or decreases in chest wall compliance, resulting in maternal hypercarboxemia.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Rostral Retraction of the Pannus and Outcomes at Cesarean Section

et al. 2016

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Objective Maternal obesity presents several challenges at cesarean section. In an effort to routinely employ a transverse suprapubic skin incision, we often retract the pannus in a rostral direction using adhesive tape placed after induction of anesthesia and before surgical preparation of the skin. We sought to understand the association between taping and neonatal cord blood gases, Apgar scores, and time from skin incision to delivery of the neonate. Study Design This is a retrospective study, performed using prospectively collected anesthesiology records with data supplemented from the patients' medical records. Singleton pregnancies with morbid obesity (body mass index [BMI] > 40 kg/m(2)) between 37 and 42 weeks of gestation who delivered via nonurgent, scheduled cesarean delivery under regional (spinal, combined spinal-epidural, or epidural) anesthesia between March 2007 and March 2013 were identified. Maternal demographics including BMI, comorbidities, type of anesthesia, time intervals during the surgery, cord gas results, and Apgar scores were collected. The relationship between taping and blood acid-base status, Apgar scores, and interval from skin incision to delivery was investigated using appropriate statistical tests. Results There were 2,525 (27.5%) cesarean deliveries out of 9,189 total deliveries. Applying the described inclusion/exclusion criteria, 141 patients were identified (33 taped and 108 nontaped). There was no significant difference in BMI between the taped (51.9 kg/m(2)) and nontaped groups (47.4 kg/m(2)), p > 0.05. There was no difference in type of anesthesia (p > 0.05). The only significant difference between the taped and not-taped groups was the presence of chronic hypertension in the taped group (p = 0.03). There were no significant differences in cord blood gas values, Apgar scores, or skin incision to delivery interval (p > 0.05 for all outcomes). Conclusions Taping of the pannus at cesarean section is a safe intervention that is not associated with adverse neonatal outcomes. Furthermore, over a set of parturients with BMI > 40 kg/m(2), it does not hasten skin incision to delivery time.

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Comparisons of the morbidity outcomes in repeated cesarean sections using midline and Pfannenstiel incisions

Abstract: Operative complications, operative time, postpartum complications and neonatal outcomes were comparable between low midline and Pfannenstiel groups in repeated cesarean sections irrespective of the previous technique used.

Cited by 7 publications

References 8 publications

Outcomes and Complications After Repeat Cesarean Sections Among King Abdulaziz University Hospital Patients

Outcomes and Complications After Repeat Cesarean Sections Among King Abdulaziz University Hospital Patients

The association of skin-incision type at cesarean with maternal and neonatal morbidity for women with multiple prior cesarean deliveries

The Relationship between Rostral Retraction of the Pannus and Outcomes at Cesarean Section

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