title: Timing and risk factors of maternal complications of cesarean section.
abstract: 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.
authors.affiliation: Perinatal Division, Helen Schneider Hospital for Women, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah-Tiqva, 49100 Tel-Aviv, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Hadar
authors.forename: Nir
authors.initials: N
authors.lastname: Melamed
authors.forename: Keren
authors.initials: K
authors.lastname: Tzadikevitch-Geffen
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
mesh_terms: 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