Abstract:
OBJECTIVE:Our aim was to estimate the incidence of unintentional hysterotomy extension at the time of cesarean delivery and to identify associated risk factors and maternal morbidity. STUDY DESIGN:We conducted a secondary analysis of a randomized controlled trial evaluating chlorhexidine-alcohol versus iodine-alcohol for skin antisepsis in women undergoing cesarean delivery. We included patients with a low transverse hysterotomy. The primary outcome was the incidence of unintentional hysterotomy extension. Logistic regression was performed to identify independent factors associated with hysterotomy extension. Maternal morbidity was compared between patients with and without extension. RESULTS:Of 1,038 patients meeting the inclusion criteria, 71 (6.8%; 95% confidence interval [CI]: 5.4-8.5%) experienced a hysterotomy extension. Of several potential risk factors assessed, the second stage of labor was the only independent predictor of hysterotomy extension (adjusted odds ratio: 10.2; 95% CI: 2.6-39.8). Hysterotomy extension was associated with increased operative time (73 vs. 55.3 minutes; p< 0.01), need for blood transfusion (relative risk: 5; 95% CI: 1.6-15.2), and rate of additional surgical injury (RR: 17; 95% CI: 6.9-41.8). CONCLUSION:Hysterotomy extensions are not infrequent at the time of cesarean delivery and are associated with increased maternal morbidity. Cesarean delivery during the second stage of labor is the main independent risk factor for hysterotomy extension.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Bligard KH,Durst JK,Stout MJ,Martin S,Cahill AG,Macones GA,Tuuli MGdoi
10.1055/s-0038-1676112subject
Has Abstractpub_date
2019-08-01 00:00:00pages
1054-1059issue
10eissn
0735-1631issn
1098-8785journal_volume
36pub_type
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journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994327
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journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-999575
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abstract:OBJECTIVE: This study aimed to examine the effects of interpregnancy weight change on pregnancy outcomes, including recurrent preeclampsia, preterm birth, small-for-gestational age (SGA), large-for-gestational age (LGA), and cesarean delivery, among women with a history of preeclampsia. We also evaluated whether these ...
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journal_title:American journal of perinatology
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journal_title:American journal of perinatology
pub_type: 杂志文章,评审
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journal_title:American journal of perinatology
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pub_type: 临床试验,杂志文章
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journal_title:American journal of perinatology
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更新日期:2002-08-01 00:00:00
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journal_title:American journal of perinatology
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journal_title:American journal of perinatology
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更新日期:2012-05-01 00:00:00
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pub_type: 杂志文章
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journal_title:American journal of perinatology
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更新日期:1998-02-01 00:00:00
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journal_title:American journal of perinatology
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journal_title:American journal of perinatology
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更新日期:2016-05-01 00:00:00
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journal_title:American journal of perinatology
pub_type: 杂志文章
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更新日期:1986-04-01 00:00:00
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journal_title:American journal of perinatology
pub_type: 杂志文章
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更新日期:2008-03-01 00:00:00
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