AI Article Synopsis
- The study aimed to compare incision-to-delivery times and outcomes for mothers and babies during primary and repeat emergent cesarean deliveries, focusing on the impact of incision type (transverse vs. vertical).
- Between 1999 and 2000, data was collected from 13 hospitals on 37,112 cesarean deliveries, with a focus on 3,525 emergent cases, finding that vertical incisions led to faster delivery but longer overall procedure times and were linked to more adverse neonatal outcomes.
- The findings suggest that while vertical incisions reduce delivery times in emergencies, they may increase risks for newborns, highlighting the need to weigh incision type carefully in cesarean deliveries.
Article Abstract
Objective: To compare incision-to-delivery intervals and related maternal and neonatal outcomes by skin incision in primary and repeat emergent cesarean deliveries.
Methods: From 1999 to 2000, a prospective cohort study of all cesarean deliveries was conducted at 13 hospitals comprising the Eunice Kennedy Shriver National Institute of Child Health and Human Development's Maternal-Fetal Medicine Units Network. This secondary analysis was limited to emergent procedures, defined as those performed for cord prolapse, abruption, placenta previa with hemorrhage, nonreassuring fetal heart rate tracing, or uterine rupture. Incision-to-delivery intervals, incision-to-closure intervals, and maternal outcomes were compared by skin-incision type (transverse compared with vertical) after stratifying for primary compared with repeat singleton cesarean delivery. Neonatal outcomes were compared by skin-incision type.
Results: Of the 37,112 live singleton cesarean deliveries, 3,525 (9.5%) were performed for emergent indications of which 2,498 (70.9%) were performed by transverse and the remaining 1,027 (29.1%) by vertical incision. Vertical skin incision shortened median incision-to-delivery intervals by 1 minute (3 compared with 4 minutes, P<.001) in primary and 2 minutes (3 compared with 5 minutes, P<.001) in repeat cesarean deliveries. Total median operative time was longer after vertical skin incision by 3 minutes in primary (46 compared with 43 minutes, P<.001) and 4 minutes in repeat cesarean deliveries (56 compared with 52 minutes, P<.001). Neonates delivered through a vertical incision were more likely to have an umbilical artery pH of less than 7.0 (10% compared with 7%, P=.02), to be intubated in the delivery room (17% compared with 13%, P=.001), or to be diagnosed with hypoxic ischemic encephalopathy (3% compared with 1%, P<.001).
Conclusion: In emergency cesarean deliveries, neonatal delivery occurred more quickly after a vertical skin incision, but this was not associated with improved neonatal outcomes.
Level Of Evidence: II.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228350 | PMC |
| http://dx.doi.org/10.1097/AOG.0b013e3181df937f | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Vestibular Marginal Skin Excision Technique for Minor Secondary Unilateral Cleft Nose Deformity.
J Craniofac Surg
October 2024
Health of Science Faculty School of Human Medicine, Peruvian University Union (UpeU).
Background: Unilateral cleft lip secondary nasal deformities are common and require surgical correction frequently. The nasal dome on the cleft side is depressed, and the nasal ala is in an extended and flattened position compared with the noncleft side. In addition, the nasal septum is deviated into the cleft nostril.
View Article and Find Full Text PDFSevere palmoplantar keratoderma: a cutaneous complication from sub-optimally controlled type 2 diabetes.
Endocrinol Diabetes Metab Case Rep
January 2025
Summary: Palmoplantar keratoderma (PPK), characterised by excessive epidermal thickening of the skin on the palms and/or plantar surfaces of the feet, can be hereditary or acquired. Here, we report a case of a 53-year-old woman with a history of sub-optimally controlled diabetes mellitus presenting with fevers and decreased Glasgow Coma Scale (GCS) to a tertiary hospital. She was diagnosed with diabetic ketoacidosis (DKA), with blood glucose at 40 mmol/L and ketones at 7 mmol/L, in the setting of a methicillin-sensitive Staphylococcus aureus necrotising soft tissue back infection.
View Article and Find Full Text PDFBiplanar Lateral Hemi-Wedge Osteotomy for the Correction of Severe Tibial Varus Deformity.
Arthrosc Tech
December 2024
Department for Orthopedics and Trauma Surgery, Martin Luther Hospital Berlin, Berlin, Germany.
Indication for this hemi-wedge high tibial osteotomy is the combination of medial osteoarthritis or cartilage damage, varus deformity of >10°, and medial proximal tibial angle of <80°. The proximal lateral tibia is exposed via a skin incision of approximately 10 cm length between the tibial tuberosity and the head of the fibula. After detachment of the anterior tibial muscle, a first oblique guidewire marks the main osteotomy plane and a second guidewire marks the hemi-wedge.
View Article and Find Full Text PDFA Stepwise Approach to Surgical Decision-making for Lower Eyelid Ectropion: Insights from a Retrospective Study.
Aesthet Surg J
December 2024
Department of Plastic and Reconstructive Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China.
Background: Cicatricial lower-eyelid ectropion is a serious complication resulting from undesired lower lid blepharoplasty or impaired wound healing. Surgical treatment for ectropion is challenging for oculoplastic surgeons due to the unpredictability of surgical outcome and the difficulty of surgical design.
Objectives: The authors aimed to fully describe the surgical decision-making strategy for cicatricial ectropion, and to potentially enhance treatment outcomes.
A single-centre randomised controlled trial comparing the standard method and target-controlled infusion as a method of administering cefoxitin, which is used to prevent surgical site infections in colorectal surgical patients: study protocol.
Trials
January 2025
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
Background: Prophylactic parenteral administration of antibiotics is strongly recommended to prevent surgical site infection (SSI). Cefoxitin is mainly administered intravenously in colorectal surgery. The current standard method for administering prophylactic antibiotics in adults is to administer a fixed dose quickly before skin incision.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!