Maternal and neonatal outcomes of repeat cesarean delivery in women with a prior classical versus low transverse uterine incision.
We compared maternal and neonatal outcomes following repeat cesarean delivery (CD) of women with a prior classical CD with those with a prior low transverse CD. The Maternal Fetal Medicine Units Network Cesarean Delivery Registry was used to identify women with one previous CD who underwent an elective repeat CD prior to the onset of labor at ≥36 weeks. Outcomes were compared between women with a previous classical CD and those with a prior low transverse CD. Of the 7936 women who met study criteria, 122 had a prior classical CD. Women with a prior classical CD had a higher rate of classical uterine incision at repeat CD (12.73% versus 0.59%; P < 0.001), had longer total operative time and hospital stay, and had higher intensive care unit admission. Uterine dehiscence was more frequent in women with a prior classical CD (2.46% versus 0.27%, odds ratio 9.35, 95% confidence interval 1.76 to 31.93). After adjusting for confounding factors, there were no statistical differences in major maternal or neonatal morbidities between groups. Uterine dehiscence was present at repeat CD in 2.46% of women with a prior classical CD. However, major maternal morbidities were similar to those with a prior low transverse CD.
Bakhshi
Tiki
T
Departments of Obstetrics and Gynecology, The University of Texas Health Science Center at Houston, Houston, Texas, USA. tiki.bakhshi@amedd.army.mil
Landon
Mark B
MB
Lai
Yinglei
Y
Spong
Catherine Y
CY
Rouse
Dwight J
DJ
Leveno
Kenneth J
KJ
Varner
Michael W
MW
Caritis
Steve N
SN
Meis
Paul J
PJ
Wapner
Ronald J
RJ
Sorokin
Yoram
Y
Miodovnik
Menachem
M
Carpenter
Marshall
M
Peaceman
Alan M
AM
O'Sullivan
Mary J
MJ
Sibai
Baha M
BM
Langer
Oded
O
Thorp
John M
JM
Mercer
Brian M
BM
D000328:Adult; D017604:Cesarean Section, Repeat / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015999:Multivariate Analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome; D055815:Young Adult
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