Significance of accidental extensions in the lower uterine segment during cesarean delivery

American Journal of Obstetrics and Gynecology
Lesley de la TorreMakbib Diro

Abstract

This study was undertaken to determine risk factors and perioperative complications associated with accidental extensions in the lower uterine segment during cesarean deliveries (CDs). This is a retrospective chart review of all CDs performed at Jackson Memorial Hospital/University of Miami between the years 1999 and 2002. Operative reports were reviewed to abstract data on the occurrence of extensions. Indication for CD, cervical status at the time of CD, birth weight, and fetal presentation and position were included in the analyses. Postoperative hematocrits, length of surgery, estimated blood loss, decline in hematocrit by 10%, need for transfusion, or hysterectomy were compared among CD with and without extensions. A total of 2,811 CDs were available for this study. Accidental extensions in the lower uterine segment occurred in 6.6% of the cases. Extensions were more commonly found in primary CD (8% vs 5%, P < .01. Extensions were more frequent if cervical dilatation was 8 cm or greater (18.3% vs 7%, P < .01), complete effacement (15% vs 8%, P < .01) station greater than +1 (16% vs 6.9%, P < .01), and if the fetal position was noted to be in the occiput posterior position (10% vs 5%, P < .01). When extensions were present,...Continue Reading

References

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Citations

Dec 3, 2014·Journal de gynécologie, obstétrique et biologie de la reproduction·O ParantF Bayoumeu
Mar 21, 2007·Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN·Renee T Ridley
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Mar 23, 2018·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·Lauren E GiugaleElizabeth E Krans
Jan 3, 2021·International Urogynecology Journal·Henry H ChillDavid Shveiky
Aug 17, 2021·BJOG : an International Journal of Obstetrics and Gynaecology·K D Van WinsenP J Steer

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