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Class III Obese Women's Preferences and Concerns for Cesarean Skin Incision: A Multicenter Survey
Marcela C Smid1, Rodney K Edwards2, Joseph R Biggio2
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
American Journal of Perinatology
|August 18, 2016
Summary
Class III obese women prioritize maternal and fetal safety for cesarean delivery (CD) skin incisions. Immediate safety concerns, such as infant well-being and infection risk, outweigh cosmetic outcomes in CD preferences.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Oncology
Background:
- Class III obesity (BMI ≥ 40 kg/m²) presents unique challenges in cesarean delivery (CD).
- Patient preferences and concerns regarding surgical incisions are crucial for informed consent and satisfaction.
Purpose of the Study:
- To assess the preferences and concerns of women with class III obesity concerning cesarean delivery skin incisions.
- To identify key priorities influencing decision-making about CD incision characteristics.
Main Methods:
- An anonymous survey was administered to 546 women with class III obesity across five National Perinatal Research Consortium (NPRC) sites.
- Participants evaluated seven domains related to cesarean skin incisions, including maternal/fetal safety, pain, future pregnancy risk, breastfeeding, operative time, and cosmetic appearance.
Main Results:
- Nearly all women (99%) prioritized infant well-being and reducing incision opening/infection risk.
- Concerns about minimizing pain (95%), future pregnancy complications (90%), and breastfeeding interference (87%) were highly rated.
- Cosmetic outcomes (least visible incision) were a lower priority for 68% of participants.
Conclusions:
- Women with class III obesity prioritize immediate maternal and fetal safety above other factors when considering cesarean delivery skin incisions.
- This highlights the importance of addressing core safety concerns in patient-centered care for this population.
