TY - JOUR
T1 - Uterine incision-to-delivery interval and perinatal outcomes in transverse versus vertical incisions in preterm cesarean deliveries
AU - Luthra, Gauri
AU - Gawade, Prasad
AU - Starikov, Roman
AU - Markenson, Glenn
PY - 2013/12/1
Y1 - 2013/12/1
N2 - Objective: To compare the uterine incision-to-delivery interval and neonatal and maternal complications in vertical versus transverse uterine incisions in preterm cesarean births. Methods: This is a retrospective cohort study of singleton cesarean deliveries from 2002 to 2009 between 23 and 34 weeks of gestation. Statistical analysis utilized Wilcoxon rank-sum test and multivariable logistic regression. Results: Of the 773 singleton cesarean deliveries, 586 (75.8%) had a transverse uterine incision and 187 (24.2%) had vertical uterine incision (classical=134 and low vertical incision=53). After adjusting for confounders, there was no significant difference in incision-to-delivery interval between the two types of incisions. The risk for maternal transfusion was higher among those with a vertical incision (odds ratio: 2.17; 95% confidence interval: 1.00, 4.67) than those with a transverse incision. Incision type was not associated with any neonatal outcomes studied, including intraventricular hemorrhage, Apgar scores and neonatal mortality. Conclusion: We observed no difference in Uterine Incision-to-Delivery interval and neonatal complications between vertical and transverse incision. Performance of a vertical uterine incision for the sole reason of facilitating a more rapid delivery is not justified. Development of methods to better determine transverse incision feasibility may facilitate a decrease in vertical uterine incisions.
AB - Objective: To compare the uterine incision-to-delivery interval and neonatal and maternal complications in vertical versus transverse uterine incisions in preterm cesarean births. Methods: This is a retrospective cohort study of singleton cesarean deliveries from 2002 to 2009 between 23 and 34 weeks of gestation. Statistical analysis utilized Wilcoxon rank-sum test and multivariable logistic regression. Results: Of the 773 singleton cesarean deliveries, 586 (75.8%) had a transverse uterine incision and 187 (24.2%) had vertical uterine incision (classical=134 and low vertical incision=53). After adjusting for confounders, there was no significant difference in incision-to-delivery interval between the two types of incisions. The risk for maternal transfusion was higher among those with a vertical incision (odds ratio: 2.17; 95% confidence interval: 1.00, 4.67) than those with a transverse incision. Incision type was not associated with any neonatal outcomes studied, including intraventricular hemorrhage, Apgar scores and neonatal mortality. Conclusion: We observed no difference in Uterine Incision-to-Delivery interval and neonatal complications between vertical and transverse incision. Performance of a vertical uterine incision for the sole reason of facilitating a more rapid delivery is not justified. Development of methods to better determine transverse incision feasibility may facilitate a decrease in vertical uterine incisions.
KW - Maternal and neonatal morbidity
KW - Obstetric surgical procedures
KW - Uterine incision
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U2 - 10.3109/14767058.2013.811226
DO - 10.3109/14767058.2013.811226
M3 - Article
C2 - 23834536
AN - SCOPUS:84887911455
VL - 26
SP - 1788
EP - 1791
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
SN - 1476-7058
IS - 18
ER -