Uterine Scar Healing After Cesarean Section: Managing an Old Surgery in an Evidence-Based Environment

Laganà, Antonio Simone; Cromi, Antonella; Tozzi, Roberto; Franchi, Massimo Piergiuseppe; Lukanović, David; Ghezzi, Fabio

doi:10.1080/08941939.2018.1465145

Cited by 25 publications

(26 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, as with all surgical operations, CS exposes the woman and the infant to relevant immediate as well as long term health risks, potentially affecting also the course and outcome of subsequent pregnancies [1][2][3][4][5][6][7][8][9] . The main obstetric complications associated with CS include maternal death, post-partum infection, uterine rupture, bladder injury, abnormal placentation, ectopic pregnancy, stillbirth, preterm birth, other 2,[10][11][12] . Further, there is also growing evidence that CS may alter the hormonal and micro-biological physiology of the infant, compromising the flora of the gut and potentially increasing the risk of allergies by interfering with the development of the child's immune system.…”

mentioning

confidence: 99%

Understanding Factors Leading to Primary Cesarean Section and Vaginal Birth After Cesarean Delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015

Cegolon

Mastrangelo

Maso

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Although there is no evidence that elevated rates of cesarean sections (cS) translate into reduced maternal/child perinatal morbidity or mortality, cS have been increasingly overused almost everywhere, both in high and low-income countries. the primary cesarean section (pcS) has become a major driver of the overall cS (ocS) rate, since it carries intrinsic risk of repeat cS (RcS) in future pregnancies. in our study we examined patterns of pcS, pl compared with planned toLAc anned PCS (PPCS), vaginal birth after 1 previous CS (VBAC-1) and associated factors in Friuli Venezia Giulia (FVG), a region of NorthEastern Italy, collecting data from its 11 maternity centres (coded from A to K) during 2005-2015. By fitting three multiple logistic regression models (one for each delivery mode), we calculated the adjusted rates of pcS and ppcS among women without history of cS, whilst the calculation of the VBAC rate was restricted to women with just one previous CS (VBAC-1). Results, expressed as odds ratio (OR) with 95% confidence interval (95%CI), were controlled for the effect of hospital, calendar year as well as several factors related to the clinical and obstetric conditions of the mothers and the newborn, the obstetric history and socio-demographic background. in fVG during 2005-2015 there were 24,467 OCS (rate of 24.2%), 19,565 PCS (19.6%), 7,736 PPCS (7.7%) and 2,303 VBAC-1 (28.4%). We found high variability of delivery mode (DM) at hospital level, especially for pcS and ppcS. Breech presentation was the strongest determinant for pcS as well as ppcS. Leaving aside placenta previa/abuptio placenta/ante-partum hemorrhage, further significant factors, more importantly associated with pcS than ppcS were non-reassuring fetal status and obstructed labour, followed by (in order of statistical significance): multiple birth; eclampsia/pre-eclampsia; maternal age 40-44 years; placental weight 600-99 g; oligohydramios; pre-delivery LoS 3-5 days; maternal age 35-39 years; placenta weight 1,000-1,500 g; birthweight < 2,000 g; maternal age ≥ 45 years; pre-delivery LoS ≥ 6 days; mother's age 30-34 years; low birthweight (2,000-2,500 g); polyhydramnions; cord prolaspe; ≥6 US scas performed during pregnancy and pre-term gestations (33-36 weeks). Significant factors for PPCS were (in order of statistical significance): breech presentation; placenta previa/abruptio placenta/ante-partum haemorrhage; multiple birth; pre-delivery LoS ≥ 3 days; placental weight ≥ 600 g; maternal age 40-44 years; ≥6 US scans performed in pregnancy; maternal age ≥ 45 and 35-39 years; oligohydramnios; eclampsia/pre-eclampsia; mother's age 30-34 years; birthweight

show abstract

mentioning

confidence: 99%

Understanding Factors Leading to Primary Cesarean Section and Vaginal Birth After Cesarean Delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015

Cegolon

Mastrangelo

Maso

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…10 The rates of pelvic pain, deep dyspareunia, profuse bleeding requiring laparotomic hysterectomy, unintentional transvesical caesarean section requiring bladder repair, female postpartum sexual dysfunction, and spontaneous miscarriage were also common after cesarean section. [11][12][13][14][15] Although the majority of cesarean birth is performed for a condition that might pose a threat to both the mother and her fetus, if vaginal delivery occurred, cesarean birth can never be entirely safe and when it is performed without medical need it puts mothers and their babies at risk of short-and longterm health problems which are higher than those associated with vaginal birth, therefore, is not an alternative to vaginal delivery. [16][17][18][19] World Health Organization (WHO) has recommended that the cesarean section rate should lie between 5% and 15% to have an optimal impact since no additional benefit for newborns or mothers is obtained beyond this level.…”

Section: Introductionmentioning

confidence: 99%

<p>Magnitude of Cesarean Section Delivery and Its Associated Factors Among Mothers Who Gave Birth at Public Hospitals in Northern Ethiopia: Institution-Based Cross-Sectional Study</p>

Ayalew

Mengistie

Dheressa

et al. 2020

JMDH

View full text Add to dashboard Cite

“…This observation could be a result of adhesions, uterine and/or abdominal scars or isthmocele, a defect in the CS uterine scar, arising after a CS. Despite many authors investigating the best surgical approach for CS in order to minimize such long-term complications, no evidence is available 30 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of pelvic floor dysfunction 6 years after uncomplicated vaginal versus elective cesarean deliveries: a cross-sectional study

Baud

Sichitiu

Lombardi

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Clinicians and patients have traditionally believed that elective cesarean section may protect against certain previously ineluctable consequences of labor, including a plethora of urinary, anorectal and sexual dysfunctions. We aimed to evaluate fecal, urinary and sexual symptoms 6 years postpartum, comparing uncomplicated vaginal delivery and elective cesarean delivery, and to assess their impact on quality of life. We conducted a cross-sectional study to compare perineal functional symptomatology between women having singleton elective cesarean deliveries (eCS) and singleton uncomplicated vaginal deliveries (uVD). Women who delivered 6 years before this study were chosen randomly from our hospital database. This database includes demographic, labor, and delivery information, as well as data regarding maternal and neonatal outcomes, all of which is collected at the time of delivery by the obstetrician. Four validated self-administrated questionnaires were sent by post to the participants: the short forms of the Urogenital Distress Inventory, Incontinence Impact Questionnaire, Wexner fecal incontinence scale, and Female Sexual Function Index. Current socio-demographic details, physical characteristics, obstetrical history and mode of delivery at subsequent births were also registered using a self-reported questionnaire. A total of 309 women with uVD and 208 with eCS returned postal questionnaires. The response rate was 49%. Socio-demographic characteristics and fecal incontinence were similar between groups. After eCS, women reported significantly less urgency urinary incontinence (adjusted Relative Risk 0.55; 95% confidence interval 0.34–0.88) and stress incontinence (adjusted Relative Risk 0.53; 95% confidence interval 0.35–0.80) than after uVD. No difference in total Incontinence Impact Questionnaire score was found between both modes of delivery. Lower abdominal or genital pain (adjusted Relative Risk 1.58; 95% confidence interval 1.01–2.49) and pain related to sexual activity (adjusted Relative Risk 2.50; 95% confidence interval 1.19–5.26) were significantly more frequent after eCS than uVD. Six years postpartum, uVD is associated with urinary incontinence, while eCS is associated with sexual and urination pain.

show abstract

Uterine Scar Healing After Cesarean Section: Managing an Old Surgery in an Evidence-Based Environment

Cited by 25 publications

References 9 publications

Understanding Factors Leading to Primary Cesarean Section and Vaginal Birth After Cesarean Delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015

Understanding Factors Leading to Primary Cesarean Section and Vaginal Birth After Cesarean Delivery in the Friuli-Venezia Giulia Region (North-Eastern Italy), 2005–2015

<p>Magnitude of Cesarean Section Delivery and Its Associated Factors Among Mothers Who Gave Birth at Public Hospitals in Northern Ethiopia: Institution-Based Cross-Sectional Study</p>

Comparison of pelvic floor dysfunction 6 years after uncomplicated vaginal versus elective cesarean deliveries: a cross-sectional study

Contact Info

Product

Resources

About