Prolonged operative time of cesarean is a risk marker for subsequent cesarean maternal complications

Nun, Eyal Lang Ben; Sela, Hen Y.; Joseph, Jordanna; Rudelson, Galit; Grisaru‐Granovsky, Sorina; Rottenstreich, Misgav

doi:10.1007/s00404-022-06575-4

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…It is influenced by several factors. Rottenstreich et al reported a mean time of 30 to 66 min for repeat cesarean sections, 9 which is consistent with our findings.…”

Section: Discussionsupporting

confidence: 93%

The association between indications for cesarean delivery and surgery time

Gabbai,

Lavie,

Yogev

et al. 2023

Intl J Gynecology & Obste

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ObjectiveWe aimed to determine risk factors for prolonged surgery time of cesarean delivery (CD).MethodsWe conducted a retrospective cohort study in a single tertiary university–affiliated medical center (2011–2022). The study group consisted of all women who underwent CD that lasted >90 min (representing the 95th percentile of CD length in our cohort). Data were compared with CDs with an operation time of <90 min. Demographic, obstetric, and surgical characteristics, as well as indications for surgery and urgency (in labor vs. elective surgery), were compared.ResultsOverall, during the study period, 31 660 CDs were performed in our center. Of them, 1397 (4.4%) lasted >90 min.After applying a multivariate analysis, abnormal placentation (relative risk [RR] 1.5 [95% confidence interval (CI), 1.3–1.8]), previous uterine scar (RR, 2.15 [95% CI, 1.5–3.0]), general anesthesia (RR, 3.5 [95% CI, 2.9–4.4]) and preterm delivery (RR, 2.06 [95% CI, 1.78–2.4]) were found to be associated with prolonged surgical time. CD due to malpresentation (RR, 0.57 [95% CI, 0.46–0.7]), multiple gestations (RR, 0.72 [95% CI, 0.6–0.9]), and patient request (RR, 0.56 [95% CI, 0.38–0.84]) were found to be protective factors.ConclusionThe main risk factors associated with additional surgery time in CD are general anesthesia, abnormal placentation, previous uterine scar, and preterm delivery.

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“…It is influenced by several factors. Rottenstreich et al reported a mean time of 30 to 66 min for repeat cesarean sections, 9 which is consistent with our findings.…”

Section: Discussionsupporting

confidence: 93%

The association between indications for cesarean delivery and surgery time

Gabbai,

Lavie,

Yogev

et al. 2023

Intl J Gynecology & Obste

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“…As a result of difficulties in obtaining long-term follow-up data, the literature is mostly focused on chronic complications, such as surgical adhesions, infertility, and subfertility, as well as the life-threatening risks of hemorrhage and hysterectomy [24,25]. It has also been reported that the risk of perinatal complications and other long-term morbidities increases with the number of cesarean procedures performed, with the risk being highest in women who have had multiple cesareans [26,27].…”

Section: Introductionmentioning

confidence: 99%

Determinants of cesarean mode of childbirth among Rwandan women of childbearing age: Evidence from the 2019–2020 Rwanda Demographic and Health Survey (RDHS)

Etienne,

Aline,

Ornella

et al. 2024

Public Health Challenges

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BackgroundRwanda has made progress in reducing maternal mortality, with rates decreasing by three‐quarters between 1990 and 2015, in part due to increased access to cesarean delivery (CD). However, the prevalence of CD is also increasing for reasons other than clinical indications. Rwanda's 15% CD delivery rate is higher than World Health Organization guidelines, sparking debate about optimal CD use and potential negative outcomes in child and maternal health. This study aimed to identify the key clinical and nonclinical factors relating to CD in Rwanda.MethodsA secondary data analysis of the Rwanda Demographic and Health Survey (2019–2020) was performed, using the outcome variable of vaginal birth versus CD in women who had delivered in the survey period and for 5 years preceding. We used logistic regression modeling to identify the explanatory sociodemographic, economic, and obstetric characteristics associated with CD.ResultsMore than half of participants were between 20‐ and 34‐year old, 65.2% had completed primary school at least, 79.0% lived in rural areas, and 81.2% had health insurance. Fifteen percent of participants had given birth by CD in the preceding 5 years. CD was independently associated with higher levels of education, religion, higher socioeconomic status, perceived financial constraints, and giving birth in a private health facility. Obstetric predictors for CD included twin pregnancy, male infancy, and primiparity.ConclusionResults suggest that indications for CD should be monitored and the birthing preferences of women further evaluated, with guidelines implemented to inform decision‐making around CD.

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“…Increased epidural time may be due to scoliosis, obesity, or residents in training; increased cesarean delivery time may be due to all those factors as well as obstetric hemorrhage, adhesions from previous surgeries, or surgical complications. 9 The skewed distribution makes the use of average workload measures especially problematic, since the mean is the measure of central tendency most affected by outliers. However, even if using medians and nonparametric analysis, it is still essential to accommodate the effects of extreme situations and unpredicted outliers on workload (the skewed "tail" of the workload frequency distribution) and, hence, on workforce requirement.…”

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confidence: 99%