The Effect of Cesarean Delivery Skin Incision Approach in Morbidly Obese Women on the Rate of Classical Hysterotomy
Objective. To assess the risk of classical hysterotomy and surgical morbidity among women with a body mass index (BMI) greater than 40 kg/m2 who underwent a supraumbilical incision at the time of cesarean delivery. Methods. We conducted a retrospective cohort study in women having a BMI greater tha...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Journal of Pregnancy |
| Online Access: | http://dx.doi.org/10.1155/2013/890296 |
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| _version_ | 1832568108569591808 |
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| author | Brian E. Brocato Edwin M. Thorpe Luis M. Gomez Jim Y. Wan Giancarlo Mari |
| author_facet | Brian E. Brocato Edwin M. Thorpe Luis M. Gomez Jim Y. Wan Giancarlo Mari |
| author_sort | Brian E. Brocato |
| collection | DOAJ |
| description | Objective. To assess the risk of classical hysterotomy and surgical morbidity among women with a body mass index (BMI) greater than 40 kg/m2 who underwent a supraumbilical incision at the time of cesarean delivery. Methods. We conducted a retrospective cohort study in women having a BMI greater than 40 kg/m2 who underwent a cesarean delivery of a live, singleton pregnancy from 2007 to 2011 at a single tertiary care institution. Intraoperative and postoperative outcomes were compared between patients undergoing supraumbilical vertical (cohort, ) or Pfannenstiel (controls, ) skin incisions. Results. Women undergoing supraumbilical incisions had a higher risk of classical hysterotomy (OR, 24.6; 95% CI, 9.0–66.8), surgical drain placement (OR, 6.5; 95% CI, 2.6–16.2), estimated blood loss greater than 1 liter (OR, 3.4; 95% CI, 1.4–8.4), and longer operative time (97 ± 38 minutes versus 68 ± 30 minutes; ) when compared to subjects with Pfannenstiel incisions (controls). There was no difference in the risk of wound complication between women undergoing supraumbilical or Pfannenstiel incisions (OR, 2.7; 95% CI, 0.9–8.0). Conclusion. In women with a BMI above 40 kg/m2, supraumbilical incision at the time of cesarean delivery is associated with a greater risk of classical hysterotomy and operative morbidity. |
| format | Article |
| id | doaj-art-d42e3ee41df54fcf98087eb268aeab8d |
| institution | Kabale University |
| issn | 2090-2727 2090-2735 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Pregnancy |
| spelling | doaj-art-d42e3ee41df54fcf98087eb268aeab8d2025-02-03T00:59:49ZengWileyJournal of Pregnancy2090-27272090-27352013-01-01201310.1155/2013/890296890296The Effect of Cesarean Delivery Skin Incision Approach in Morbidly Obese Women on the Rate of Classical HysterotomyBrian E. Brocato0Edwin M. Thorpe1Luis M. Gomez2Jim Y. Wan3Giancarlo Mari4Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, 853 Jefferson Avenue Suite E102, Memphis, TN 38163, USADepartment of Obstetrics and Gynecology, University of Tennessee Health Science Center, 853 Jefferson Avenue Suite E102, Memphis, TN 38163, USADepartment of Obstetrics and Gynecology, University of Tennessee Health Science Center, 853 Jefferson Avenue Suite E102, Memphis, TN 38163, USADepartment of Preventive Medicine, University of Tennessee Health Science Center, 853 Jefferson Avenue Suite E102, Memphis, TN 38163, USADepartment of Obstetrics and Gynecology, University of Tennessee Health Science Center, 853 Jefferson Avenue Suite E102, Memphis, TN 38163, USAObjective. To assess the risk of classical hysterotomy and surgical morbidity among women with a body mass index (BMI) greater than 40 kg/m2 who underwent a supraumbilical incision at the time of cesarean delivery. Methods. We conducted a retrospective cohort study in women having a BMI greater than 40 kg/m2 who underwent a cesarean delivery of a live, singleton pregnancy from 2007 to 2011 at a single tertiary care institution. Intraoperative and postoperative outcomes were compared between patients undergoing supraumbilical vertical (cohort, ) or Pfannenstiel (controls, ) skin incisions. Results. Women undergoing supraumbilical incisions had a higher risk of classical hysterotomy (OR, 24.6; 95% CI, 9.0–66.8), surgical drain placement (OR, 6.5; 95% CI, 2.6–16.2), estimated blood loss greater than 1 liter (OR, 3.4; 95% CI, 1.4–8.4), and longer operative time (97 ± 38 minutes versus 68 ± 30 minutes; ) when compared to subjects with Pfannenstiel incisions (controls). There was no difference in the risk of wound complication between women undergoing supraumbilical or Pfannenstiel incisions (OR, 2.7; 95% CI, 0.9–8.0). Conclusion. In women with a BMI above 40 kg/m2, supraumbilical incision at the time of cesarean delivery is associated with a greater risk of classical hysterotomy and operative morbidity.http://dx.doi.org/10.1155/2013/890296 |
| spellingShingle | Brian E. Brocato Edwin M. Thorpe Luis M. Gomez Jim Y. Wan Giancarlo Mari The Effect of Cesarean Delivery Skin Incision Approach in Morbidly Obese Women on the Rate of Classical Hysterotomy Journal of Pregnancy |
| title | The Effect of Cesarean Delivery Skin Incision Approach in Morbidly Obese Women on the Rate of Classical Hysterotomy |
| title_full | The Effect of Cesarean Delivery Skin Incision Approach in Morbidly Obese Women on the Rate of Classical Hysterotomy |
| title_fullStr | The Effect of Cesarean Delivery Skin Incision Approach in Morbidly Obese Women on the Rate of Classical Hysterotomy |
| title_full_unstemmed | The Effect of Cesarean Delivery Skin Incision Approach in Morbidly Obese Women on the Rate of Classical Hysterotomy |
| title_short | The Effect of Cesarean Delivery Skin Incision Approach in Morbidly Obese Women on the Rate of Classical Hysterotomy |
| title_sort | effect of cesarean delivery skin incision approach in morbidly obese women on the rate of classical hysterotomy |
| url | http://dx.doi.org/10.1155/2013/890296 |
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