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Complications of Rapid Preterm Cesarean Delivery [18A]

Kawakita, Tetsuya, MD; Desale, Sameer, MS; Reddy, Uma M., MD

Obstetrics & Gynecology: May 2016 - Volume 127 - Issue - p 16S
doi: 10.1097/01.AOG.0000483311.42509.08
Poster Presentations: PDF Only

INTRODUCTION: There are limited data regarding the impact of rapid cesarean delivery (CD) (incision-delivery time [I-D] less than 2 minutes) on the risk of maternal operative complications.

METHODS: This was a multicenter retrospective cohort study of women undergoing CD between 23 and 31 weeks gestation between 2005 and 2014. Women with multiple gestation, maternal severe conditions (renal failure, cardiopulmonary collapse, acute respiratory distress syndrome, major trauma, and active seizure), and placenta previa/accreta were excluded. Women were categorized based on I-D (rapid group: 2 minute or less or control: greater than 2 minutes). Maternal characteristics and complications were ascertained. Multivariable regression model was created to calculate adjusted P value, controlling for maternal characteristics and pregnancy complications.

RESULTS: Of 886 women, 132 women (17.5%) had rapid CD. Rapid group was more likely to be not obese, without previous uterine scar, and to undergo general anesthesia (P<.05). Rapid group was less likely to be complicated by hypertensive disease (P<.05). In primary CD, rapid CD was associated with increased risk of endometritis (4.8% vs 11.1%; P<.05) and intensive care unit (ICU) admission (1.7% vs 6.0%; P<.05). Postpartum hemorrhage (5.3% vs 9.5%), transfusion (7.2% vs 12.0%), wound infection (2.4% vs 5.1%) appeared to be increased in rapid CD although they were not significant (P>.05). In repeat CD, rapid CD appeared to be associated with increased risk of postpartum hemorrhage (11.5% vs 28.6%) and transfusion (10.1% vs 21.4%) although they were not significant (P>.05).

CONCLUSION: Among women who underwent preterm CD, rapid CD was associated with increased risk of maternal complications.

Washington Hospital Center, Washington, DC

Financial Disclosure: The authors did not report any potential conflicts of interest.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.