Differences in outcomes between cesarean section in the second versus the first stages of labor

The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
Dana VitnerRon Gonen

Abstract

We aimed to compare maternal morbidity and mortality of cesarean sections (CS) in the second versus first stage of labor. Retrospective study of all CS at a single, university-affiliated medical center, between January 2010 and December 2014. Eligibility was limited to term, singleton pregnancies with cephalic presentation. Maternal outcomes of second-stage CS were compared to those of first-stage CS. The primary outcome was defined as estimated blood loss >1000 ml. Overall, 1004 women met the inclusion criteria, of which 290 (29%) had a second-stage CS and 714 (71%) had a first-stage CS. Women in the second-stage CS group had a higher nulliparity and hypertensive disorders rates and a lower rate of previous CS. Second-stage CS was associated with more than double the rate of estimated blood loss >1000 ml (9.7% versus 3.8%, p<.001), and more prone to unintentional uterine incision extension, uterine atony, hemoglobin decrease >2 g/l and antibiotic treatment for suspected endometritis. In a multivariable logistic regression model, second-stage CS was found to be independently associated with unintentional uterine incision extension (OR 6.8, 95% CI 4.1-11.2), uterine atony (OR 3.3, 95% CI 1.4-8.0) and antibiotic treatment for sus...Continue Reading

References

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Citations

May 15, 2020·BJOG : an International Journal of Obstetrics and Gynaecology·Osnat EzraJigal Haas
Oct 28, 2019·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Lisa D LevineSindhu K Srinivas
Dec 16, 2020·Acta Obstetricia Et Gynecologica Scandinavica·Joana G BarrosLuís M Graça
May 21, 2020·American Journal of Obstetrics and Gynecology·Joshua GuedaliaYishai Sompolinsky

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