Intraoperative surgical complication during cesarean section: an observational study of the incidence and risk factors.
BACKGROUND
The study was intended to estimate the incidence of intraoperative surgical complications with the impact of the educational level of the surgeon and a history of previous cesarean section on intraoperative complications at cesarean childbirth.


METHODS
In the period between August 1st 1995 and July 30th 1996, 7782 women gave birth at the three Obstetric Departments in Copenhagen County, Denmark, of which 929 (11.9%) were delivered by cesarean section. These women served as the study population, and their medical records were reviewed and data obtained immediately after delivery.


RESULTS
The overall intraoperative complication rate was 12.1%. The rate of complications in emergency cesarean sections was 14.5% compared with 6.8% in the elective group. The educational level of the surgeon and a history of previous cesarean section were not found to be significantly associated to intraoperative complications. Low station of the presenting part of the fetus, high fetal birth weight, fetal distress and dystocia as indications and increasing maternal age were significant risk factors of lacerations. Placenta previa and placental abruption as indications, increasing prepregnancy body mass index, as well as low and high birth weight were significant risk factors for intraoperative blood loss more than 1 l. Duration of regular painful contractions had a preventive effect.


CONCLUSIONS
Utero-cervical lacerations and blood loss of more than 1 l were the most frequent intraoperative complications in cesarean section in the present study. The educational level of the surgeon or history of a previous cesarean section were not significantly related to these complications.
Bergholt
Thomas
T
Department of Obstetrics and Gynecology in Gentofte, University of Copenhagen, Denmark. tbe@dadlnet.dk
Stenderup
Jens Karl
JK
Vedsted-Jakobsen
Agnete
A
Helm
Peter
P
Lenstrup
Carsten
C
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000473:pathology; D011247:Pregnancy; D012307:Risk Factors; D014599:Uterus / Q000293:injuries*; D014621:Vagina / Q000293:injuries*