title: Class III Obese Women's Preferences and Concerns for Cesarean Skin Incision: A Multicenter Survey.
abstract: ObjectiveThis study aims to assess class III obese women's preferences and concerns regarding cesarean delivery (CD) skin incisions.Study DesignThrough the National Perinatal Research Consortium (NPRC), women with body mass index ≥ 40 kg/m2at the time of enrollment completed an anonymous survey in English or Spanish. We evaluated seven domains of preferences and concerns about the cesarean skin incision.ResultsWe surveyed 546 women at five NPRC sites. Median age (interquartile range) was 29 (25, 35) years; 364 (66%) were parous and 161 (30%) had a prior CD. Women self-identified race/ethnicity as White (31%), non-Hispanic Black (31%), Hispanic (31%), other (6%), and not reported (1%). A total of 542 women (99%) rated both delivering the baby in the best possible condition and decreasing incision opening/infection risk as important. Women were less likely to rate other domains as important (allp< 0.001), including: having least pain possible,n= 521 (95%); decreasing the risk of complications in the next pregnancy,n= 490 (90%); decreasing interference with breastfeeding,n= 474 (87%); decreasing operative time,n= 388 (71%); and having the least visible incision,n= 369 (68%).ConclusionWomen with class III obesity prioritize immediate maternal and fetal safety regarding CD skin incision over other concerns including cosmetic outcome.
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Marcela C
authors.initials: MC
authors.lastname: Smid
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Rodney K
authors.initials: RK
authors.lastname: Edwards
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Biggio
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Karen
authors.initials: K
authors.lastname: Dorman
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Leduke
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
authors.forename: Laurie L
authors.initials: LL
authors.lastname: Lesher
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Manuck
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.
authors.forename: George R
authors.initials: GR
authors.lastname: Saade
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Salazar
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: David M
authors.initials: DM
authors.lastname: Stamilio
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Stuebe
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Alan T N
authors.initials: AT
authors.lastname: Tita
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University, New York, New York.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Torres
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.affiliation: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University, New York, New York.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects / Q000379:methods; D002921:Cicatrix / Q000209:etiology; D005260:Female; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications*; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D057240:Patient Preference; D011247:Pregnancy; D012449:Safety; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D055815:Young Adult