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Comparison of maternal outcomes from primary cesarean section during the second compared with first stage of labor by indication for the operation.

AbstractOBJECTIVE:
To compare maternal outcomes when cesarean sections were performed in the second stage of labor to those performed in the first stage of labor by indication for the operation.
STUDY DESIGN:
This is a retrospective cohort (n=383) of term parturient women who underwent primary cesarean section during active labor. Cases were drawn from the Obstetrics Department, E. Wolfson Medical Center, a tertiary health care university facility, during a 24 month period. All cases were term singleton pregnancies in vertex presentation following unremarkable pregnancy. Maternal morbidity was assessed.
RESULTS:
A significantly higher rate of unintentional uterine incision extensions was observed in cesarean sections performed during second stage compared to first stage (17.1% vs. 4.6%, p=0.001). It was higher whenever (at first or second stage) the fetal head was pushed (20.0% vs. 5.4%, p=0.0024). Unintentional uterine incision extensions were significantly more frequent when the cesarean section was performed for non-progressive labor during the second stage compared to first stage (16.1% vs. 3.6%, p=0.0052). Uterine atonia was more frequent among parturient women who underwent cesarean section for non-progressive labor during the first stage compared to second stage (16.7% vs. 4.8%, p=0.0382).
CONCLUSION:
Uterine atony during first stage cesarean section and unintentional uterine incision extensions during second stage cesarean section were significantly more frequent when the operation was performed for non-progressive labor.
AuthorsSamuel Lurie, Nili Raz, Mona Boaz, Oscar Sadan, Abraham Golan
JournalEuropean journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 182 Pg. 43-7 (Nov 2014) ISSN: 1872-7654 [Electronic] Ireland
PMID25218551 (Publication Type: Comparative Study, Journal Article, Observational Study)
CopyrightCopyright © 2014. Published by Elsevier Ireland Ltd.
Topics
  • Adult
  • Cesarean Section (adverse effects)
  • Female
  • Fetal Blood (chemistry)
  • Fetal Distress (surgery)
  • Humans
  • Hydrogen-Ion Concentration
  • Labor Stage, First
  • Labor Stage, Second
  • Operative Time
  • Pregnancy
  • Retrospective Studies
  • Time Factors
  • Uterine Hemorrhage (surgery)
  • Uterine Inertia (etiology)
  • Young Adult

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