Risk Factors and Maternal Morbidity Associated with Unintentional Hysterotomy Extension at the Time of Cesarean Delivery.


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.


Am J Perinatol


Bligard KH,Durst JK,Stout MJ,Martin S,Cahill AG,Macones GA,Tuuli MG




Has Abstract


2019-08-01 00:00:00












  • Perinatal management of enteric duplication cysts of the tongue.

    abstract::Intra-oral enteric duplication cysts are rare. We recently treated two infants with prenatally diagnosed large sublingual enteric duplication cysts. Antenatal aspiration of the cyst was attempted in one infant without success. Because of the potential for airway obstruction and respiratory distress at delivery, prepar...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Chen MK,Gross E,Lobe TE

    更新日期:1997-03-01 00:00:00

  • Third trimester ultrasonic presentation of infantile polycystic kidney disease.

    abstract::Infantile polycystic kidney disease (Potter's Type 1) is an autosomal recessive disorder that affects the kidneys and liver. Use of ultrasound to make the diagnosis prenatally is well documented and, in fact, it is advocated as a screening device for second-trimester identification of potentially affected fetuses. The...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Argubright KF,Wicks JD

    更新日期:1987-01-01 00:00:00

  • Routine Multidisciplinary Review of Severe Maternal Morbidity Is Associated with a Reduction in Preventable Cases of Severe Maternal Morbidity.

    abstract:OBJECTIVE: Severe maternal morbidity (SMM) has increased by 45% in the United States and is estimated to affect up to 1.5% of all deliveries. Research has not yet been conducted that demonstrates a benefit to multidisciplinary review of SMM. The aim of our study was to determine if standardized, routine review of the c...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Ozimek JA,Greene N,Geller A,Zakowski M,Wong MS,Franco R,Kilpatrick SJ

    更新日期:2020-08-30 00:00:00

  • Red Blood Cell Transfusions at 21 Days of Age or Older in Previously Transfusion-Naive Very Preterm Infants: Association with Neonatal Outcomes.

    abstract:OBJECTIVE:This study aims to assess the association of red blood cell (RBC) transfusion in a cohort of preterm infants with mortality, retinopathy of prematurity (ROP), and chronic lung disease (CLD) transfused at ≥21 days of life. STUDY DESIGN AND METHODS:This retrospective cohort study included infants born at <30 w...

    journal_title:American journal of perinatology

    pub_type: 杂志文章,多中心研究


    authors: Keir A,Aziz K,McMillan D,Monterrosa L,Ojah C,Lee S,Shah PS,Canadian Neonatal Network.

    更新日期:2015-10-01 00:00:00

  • Vaginal birth after cesarean delivery in a small rural community with a solo practice.

    abstract::The objective of this study is to review the safety and success of a trial of labor after cesarean in a group of patients managed by a solo practitioner in a rural community. This was a retrospective review of all deliveries performed over an 11-year period by a single practitioner in a rural community. Standard contr...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Upadhyaya CD,Upadhyaya DM,Carlan SJ

    更新日期:2003-02-01 00:00:00

  • Diabetes during Pregnancy in Low- and Middle-Income Countries.

    abstract::Objective Our objective was to review the literature in relationship to diabetes in pregnancy in low and middle income countries. Study Design We reviewed the English language literature related to diabetes and obesity during pregnancy in low and middle income countries published over the last 20 years. Results The gl...

    journal_title:American journal of perinatology

    pub_type: 杂志文章,评审


    authors: Goldenberg RL,McClure EM,Harrison MS,Miodovnik M

    更新日期:2016-11-01 00:00:00

  • Hydrographic magnetic resonance imaging of the fetal eye.

    abstract::Previous work has shown that fetal hydrographic magnetic resonance imaging (MRI) provided additional information complementary to T2-weighted single-shot fast spin echo (ssFSE) images. The objective of this study was to determine if hydrographic MRI provides better conspicuity of fetal eye structures compared with ssF...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Paquette LB,Jackson HA,Tavaré CJ,Panigrahy A

    更新日期:2012-04-01 00:00:00

  • Gastric residual in growing preterm infants: effect of body position.

    abstract::Studies of the effect of body position during and after bolus feeding upon gastric emptying or gastric residual have not had consistent results. We tested the hypotheses that right lateral decubitus leads to less gastric residual than left lateral decubitus and that the prone position leads to less gastric residual th...

    journal_title:American journal of perinatology

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Cohen S,Mandel D,Mimouni FB,Solovkin L,Dollberg S

    更新日期:2004-04-01 00:00:00

  • Characteristics of 11 neonates with atrial septal defects detected by heart murmurs.

    abstract::The aim of this prospective study was to investigate, using echocardiography, the relationship between heart murmurs found in the neonatal period and atrial septal defect (ASD). Heart murmurs were detected in 115 of 5124 term neonates within 1 month after birth. The babies were followed by echocardiographic examinatio...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Takami T,Kawashima H,Kamikawa A,Takei Y,Miyajima T,Hoshika A

    更新日期:2003-05-01 00:00:00

  • A primary cytomegalovirus infection in pregnancy presenting with unusual hematologic manifestations: a case report.

    abstract::A previously healthy multigravida woman presenting with pyrexia was found to be pancytopenic at 32 weeks' gestation. The leukopenia and the thrombocytopenia responded to supportive therapy. The anemia, which was Coombs' negative, continued and was associated with a drop in fibrinogen, but both eventually returned to n...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Soliman SR,Burrows RF

    更新日期:1993-09-01 00:00:00

  • Proficiency of Laryngeal Mask Airway Insertion Skill in NRP Certified Providers.

    abstract:OBJECTIVE: In 2015, Neonatal Resuscitation Program (NRP) recommended laryngeal mask airway (LMA) as an alternative to the endotracheal tube (ETT) in situations where the provider is "unable to intubate and unable to ventilate." LMA insertion is being taught in the NRP routinely. However, endotracheal intubation is the ...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Mani S,Rawat M

    更新日期:2020-11-29 00:00:00

  • Femur length versus biparietal diameter for estimating gestational age in the third trimester.

    abstract::It is well established that ultrasound measurement of femur length and biparietal diameter are comparably accurate estimators of gestational age when obtained in the first half of pregnancy. Both estimators, however, become less accurate later in pregnancy. The present study compares the relative accuracy of these est...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Egley CC,Seeds JW,Cefalo RC

    更新日期:1986-04-01 00:00:00

  • Maternal and fetal tuberous sclerosis complicating pregnancy: a case report and overview of the literature.

    abstract::Tuberous sclerosis complex (TSC) is an autosomal-dominant phakomatosis that can result in cardiac and central nervous system lesions and may adversely impact fetal and maternal health. We report a case of a 19-year-old primagravida with TSC whose pregnancy was complicated by preeclampsia, preterm labor, and fetal demi...

    journal_title:American journal of perinatology

    pub_type: 杂志文章,评审


    authors: King JA,Stamilio DM

    更新日期:2005-02-01 00:00:00

  • A Novel Partogram for Stages 1 and 2 of Labor Based on Fetal Head Station Measured by Ultrasound: A Prospective Multicenter Cohort Study.

    abstract:OBJECTIVE: This study was aimed to describe continuous labor curves, including second stage, based on fetal head station. STUDY DESIGN: We performed a prospective multicenter cohort study. The inclusion criteria were women with singleton uncomplicated cephalic term pregnancies in labor, who delivered vaginally. We use...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Haberman S,Atallah F,Nizard J,Buhule O,Albert P,Gonen R,Ville Y,Paltieli Y

    更新日期:2020-03-02 00:00:00

  • Re-analysis of safety data supporting doxylamine use for nausea and vomiting of pregnancy.

    abstract::Antihistamines are commonly used to treat nausea and vomiting of pregnancy (NVP). We re-analyzed the 24 primary studies cited in a 1997 meta-analysis that concluded antihistamine use for NVP was safe as they had been studied in more than 200,000 participating women and the pooled odds ratio for congenital malformation...

    journal_title:American journal of perinatology

    pub_type: 杂志文章,meta分析


    authors: Chin JW,Gregor S,Persaud N

    更新日期:2014-09-01 00:00:00

  • Factors that Influence Longitudinal Growth from Birth to 18 Months of Age in Infants with Gastroschisis.

    abstract:OBJECTIVE:This study aimed to investigate factors that influence growth in infants with gastroschisis. STUDY DESIGN:Growth parameters at birth, discharge, 6, 12, and 18 months of age were collected from 42 infants with gastroschisis. RESULTS:The mean z-scores for weight, length, and head circumference were below norm...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Nair N,Merhar S,Wessel J,Hall E,Kingma PS

    更新日期:2020-12-01 00:00:00

  • Time and number of displays impact critical signal detection in fetal heart rate tracings.

    abstract::Interest in centralized monitoring in labor and delivery units is growing because it affords the opportunity to monitor multiple patients simultaneously. However, a long history of research on sustained attention reveals these types of monitoring tasks can be problematic. The goal of the present experiment was to exam...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Anderson BL,Scerbo MW,Belfore LA,Abuhamad AZ

    更新日期:2011-06-01 00:00:00

  • Accurate ultrasonic estimation of fetal weight.

    abstract::The accuracy of eight ultrasonic fetal weight formulas were analyzed in 1099 fetuses who underwent real-time ultrasound examination within 72 hours prior to delivery. Shepard's formula was most consistently found to give the lowest systematic and random errors throughout all weight categories, though Deter's formula h...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Ott WJ,Doyle S,Flamm S

    更新日期:1985-07-01 00:00:00

  • The History and Contributions of the Diabetes in Pregnancy Study Group of North America (1997-2015).

    abstract::The Diabetes in Pregnancy Study Group of North America (DPSG-NA) was founded in 1997 in San Antonio, Texas, out of the recognition that the field of maternal-fetal medicine should support and conduct research to address the specialized needs of pregnant women with type 1, type 2, or gestational diabetes mellitus. Sinc...

    journal_title:American journal of perinatology

    pub_type: 历史文章,杂志文章


    authors: Rosen JA,Langer O,Reece EA,Miodovnik M

    更新日期:2016-11-01 00:00:00

  • A rapid and safe method to detect fetal parvovirus B19 infection in amniotic fluid by polymerase chain reaction: report of a case.

    abstract::Molecular amplification of parvovirus B19 DNA in an amniotic fluid sample was used to confirm the etiologic agent of a case with fetal hydrops. The polymerase chain reaction (PCR) method used is easy and fast to perform. We have a 2-year experience on its use in clinical parvovirus B19 diagnosis. The results are avail...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Nikkari S,Ekblad U

    更新日期:1995-11-01 00:00:00

  • The heightened significance of prolonged bradycardia associated with intrauterine growth retardation.

    abstract::The significance and management of prepartum bradycardia is not well established in prepartum fetal assessment. The incidence of prolonged bradycardia was 3.5% (45 per 1284), defined as a decrease of greater than or equal to 40 beats per minute of the fetal heart rate (FHR) below the baseline for at least 2 minutes. T...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Brustman LE,Langer O,Anyaegbunam A

    更新日期:1985-10-01 00:00:00

  • Inadequate prenatal care utilization and risks of infant mortality and poor birth outcome: a retrospective analysis of 28,729,765 U.S. deliveries over 8 years.

    abstract:OBJECTIVE:To evaluate the association between adequacy of prenatal care utilization and risk of fetal and neonatal mortality and adverse outcomes. METHODS:We conducted a population-based cohort study using the Center for Disease Control and Prevention's Linked Birth-Infant Death and Fetal Death data on all deliveries ...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Partridge S,Balayla J,Holcroft CA,Abenhaim HA

    更新日期:2012-11-01 00:00:00

  • Conservative management of abdominal gunshot wound in a pregnant woman.

    abstract::An abdominal gunshot wound in pregnancy warrants prompt surgical exploration but does not mandate uterine evacuation. Despite an entry and exit bullet wound to the uterus an apparent desire for pregnancy termination, a conservative approach was adopted with primary repair of the uterus, in conjunction with surgical re...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Kirshon B,Young R,Gordon AN

    更新日期:1988-07-01 00:00:00

  • Identification of a Pivotal Period in the Oral Feeding Progression of Preterm Infants.

    abstract:OBJECTIVE:Preterm infants are at risk of encountering oral feeding difficulties which impede on the transition to independent oral feeds. The objective of this study was to identify a pivotal period where regressions are most likely to occur during their oral feeding progression. STUDY DESIGN:This is a retrospective s...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Fucile S,Phillips S,Bishop K,Jackson M,Yuzdepski T,Dow K

    更新日期:2019-04-01 00:00:00

  • Isolated persistent fetal bradycardia in complete A-V block: a conservative approach is appropriate. A case report and a review of the literature.

    abstract::Persistent fetal bradycardia is rarely encountered during pregnancy. When it is associated with a complete atrio-ventricular (A-V) block, it may prove dangerous to the fetus or newborn. The prenatal diagnosis is vital because it necessitates close follow-up during pregnancy to detect fetal compromise and proper prepar...

    journal_title:American journal of perinatology

    pub_type: 杂志文章,评审


    authors: Rabinerson D,Gruber A,Kaplan B,Lurie S,Peled Y,Neri A

    更新日期:1997-07-01 00:00:00

  • Detection of fetal growth restriction with preterm severe preeclampsia: experience at two tertiary centers.

    abstract::Our objective was to determine if sonographic estimate of fetal weight (SEFW) can identify fetal growth restriction (FGR; birthweight < 10% for gestational age [GA]) among patients with preterm (28 to 32 weeks) severe preeclampsia (P SPE). At two centers, all singletons with reliable GA, P SPE, and SEFW within 3 weeks...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Gupta LM,Gaston L,Chauhan SP

    更新日期:2008-04-01 00:00:00

  • Transient diabetes insipidus in pregnancy complicated by hypertension and seizures.

    abstract::A case is presented of a primigravida with transient diabetes insipidus, gestational hypertension, and multiple seizures resistant to magnesium sulfate and diazepam. After addition of phenytoin, no further seizures occurred. Transient diabetes insipidus in pregnancy has been previously associated with hypertension, li...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Combs CA,Walker C,Matlock BA,Crombleholme W

    更新日期:1990-07-01 00:00:00

  • Diagnosis of preterm rupture of membranes: is testing for alpha-fetoprotein better than ferning or nitrazine?

    abstract::This article evaluates the role of alpha-fetoprotein (AFP) testing in the diagnosis of ruptured membranes in the preterm patient. AFP is normally found in amniotic fluid and is not present in vaginal secretions. Testing for AFP in vaginal fluid was compared with nitrazine evaluation and ferning in two groups of preter...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Garite TJ,Gocke SE

    更新日期:1990-07-01 00:00:00

  • Early Postnatal IGF-1 and IGFBP-1 Blood Levels in Extremely Preterm Infants: Relationships with Indicators of Placental Insufficiency and with Systemic Inflammation.

    abstract:OBJECTIVE:To evaluate to what extent indicators of placenta insufficiency are associated with low concentrations of insulin-like growth factor 1 (IGF-1) and IGF-1-binding protein-1 (IGFBP-1) in neonatal blood, and to what extent the concentrations of these growth factors are associated with concentrations of proteins w...

    journal_title:American journal of perinatology

    pub_type: 杂志文章


    authors: Leviton A,Allred EN,Fichorova RN,VanderVeen DK,O'Shea TM,Kuban K,Dammann O,ELGAN Study Investigators.

    更新日期:2019-12-01 00:00:00

  • Fetal and neonatal cytopenias: what have we learned?

    abstract::Rh disease has largely disappeared as a result of prophylaxis with anti-D. However, the cases that remain are more complicated with a combination of novel challenges with regard to in utero management with transfusion and its effects on the course of the neonate, both early and late. Thrombocytopenia in the neonate ca...

    journal_title:American journal of perinatology

    pub_type: 杂志文章,评审


    authors: Bussel JB

    更新日期:2003-11-01 00:00:00