Related Experiment Video
Updated: Mar 12, 2026
08:49
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
16.0K
Maternal outcomes associated with early preterm cesarean delivery
Tetsuya Kawakita1, Uma M Reddy1, Katherine L Grantz1
1Obstetrics and Gynecology at MedStar Washington Hospital Center, Washington, DC.
American Journal of Obstetrics and Gynecology
|November 15, 2016
Summary
Classic cesarean delivery showed no increased maternal complications before 28 weeks gestation. However, after 28 weeks, classic cesarean delivery was linked to higher rates of postpartum hemorrhage, transfusion, endometritis, and ICU admission compared to low transverse cesarean.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Outcomes Research
Background:
- Conflicting data exist regarding maternal complications associated with classic cesarean delivery.
- The lower uterine segment is thicker in extremely preterm deliveries (22 0/7–27 6/7 weeks' gestation), potentially altering complication rates.
- It is hypothesized that maternal complication rates may not differ between classic and low transverse cesarean approaches in certain gestational ranges.
Purpose of the Study:
- To compare maternal outcomes between classic and low transverse cesarean deliveries.
- To stratify comparisons by gestational age, specifically focusing on 23 0/7–27 6/7 weeks and 28 0/7–31 6/7 weeks' gestation.
Main Methods:
- A retrospective cohort study involving 902 women undergoing cesarean delivery between 23 0/7 and 31 6/7 weeks' gestation (2005–2014).
- Comparison of a composite maternal outcome (including postpartum hemorrhage, transfusion, endometritis, sepsis, wound infection, DVT/PE, hysterectomy, respiratory complications, ICU admission) between classic and low transverse cesarean.
- Multivariable logistic regression was used to control for maternal characteristics, emergency delivery, and comorbidities, with analyses stratified by gestational age.
Main Results:
- No significant increase in maternal complications was observed for classic cesarean compared to low transverse cesarean between 23 0/7 and 27 6/7 weeks' gestation.
- Between 28 0/7 and 31 6/7 weeks' gestation, classic cesarean was associated with significantly higher risks of the composite maternal outcome (aOR, 1.95), transfusion (aOR, 2.42), endometritis (aOR, 3.23), and ICU admission (aOR, 5.05) compared to low transverse cesarean.
- A total of 221 women underwent classic cesarean between 23 0/7 and 27 6/7 weeks, and 91 women underwent classic cesarean between 28 0/7 and 31 6/7 weeks.
Conclusions:
- Classic cesarean delivery is associated with higher maternal complication rates compared to low transverse cesarean, specifically in the gestational age range of 28 0/7 to 31 6/7 weeks.
- No increased maternal complication risk was found for classic cesarean versus low transverse cesarean between 23 0/7 and 27 6/7 weeks' gestation.
- These findings suggest that gestational age is a critical factor when considering the risks associated with different cesarean delivery techniques.
Related Concept Videos
01:20Pathophysiology of Diabetes
4.1K
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
4.1K
01:07Teratogenicity
4.4K
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
4.4K