Timing and risk factors of maternal complications of cesarean section.
OBJECTIVE
To investigate the timing and risk factors of maternal complications of cesarean section (CS).


METHODS
Review of the files of all women who underwent CS at a tertiary medical center between September 2007 and December 2008 yielded 100 patients with postpartum complications. Their clinical and surgery-related characteristics were compared with 100 women with uncomplicated CS operated in January 2009. Complications were analyzed by prevalence and time of occurrence.


RESULTS
The only between-group difference in background factors was a higher rate of obesity (BMI > 30) in the controls. The complication rate was 5.7%. The most common complication was endomyometritis (3.6%), followed by wound infection (1.8%) and wound hematoma (1.2%). In most cases, endomyometritis was diagnosed on postoperative days 2-3 and wound complications on days 2-5; 7 of the 9 readmissions occurred on postoperative days 5-6. On multivariate analysis, significant independent predictors of postoperative complications were surgeon experience (OR = 2.4, 95% CI 1.2-4.8) and intra-partum CS (OR = 2.1, 95% CI 1.1-4.3).


CONCLUSIONS
Cesarean section performed by a resident or during active labor is associated with an increased risk of postpartum complications. Medical teams should be alert to morbidity in women at risk, particularly during the first 4 days after CS.
Hadar
Eran
E
Perinatal Division, Helen Schneider Hospital for Women, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah-Tiqva, 49100 Tel-Aviv, Israel.
Melamed
Nir
N
Tzadikevitch-Geffen
Keren
K
Yogev
Yariv
Y
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors