Objectives: Classical cesarean section may be associated with increased short- and long-term risks. The objectives of this study were to review the following systematically: first, the short-term maternal and infant risks with preterm classical compared with low transverse cesarean sections; and second, the risk of spontaneous or early-labour uterine rupture.
Data Sources: Medline, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from January 1980 to July 2018.
Study Selection: A total of 772 studies were independently screened by two reviewers, and 91 full texts were reviewed. The review included nine studies comparing outcomes after preterm classical versus low transverse cesarean section and 15 studies addressing subsequent pregnancy outcomes.
Data Synthesis: Our primary short-term outcomes were maternal death and intensive care unit (ICU) admission. For subsequent pregnancies, our primary outcome was the risk of spontaneous or early-labour uterine rupture. The data were synthesized using random effects, and odds ratios (ORs) and 95% confidence intervals (CIs) were generated. There were no significant differences between preterm classical and low transverse cesarean sections in the odds of maternal death (OR 2.38; 95% CI 0.15-38.07) or ICU admission (adjusted OR 2.38; 95% CI 0.42-13.35). A subgroup from 28 to 31 weeks gestation had increased risks of endometritis, transfusion, and ICU admission with the classical incision. The low vertical incision was associated with a lower odds of organ injury than was the low transverse incision. The incidence of uterine rupture following the classical incision without a trial of labour was 1%.
Conclusion: Preterm classical cesarean section is not associated with significantly increased risks, but data are scarce. Subsequent uterine rupture risk when not planning a trial of labour is 1%.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jogc.2019.02.015 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Minimal invasive surgery protects against severe postoperative complications regardless of body composition in patients undergoing colorectal surgery.
Eur J Surg Oncol
December 2024
Zuyderland Medical Centre Sittard/Heerlen, the Netherlands.
Background: For many colorectal cancer patients, primary surgery is the standard care of treatment. Further insights in perioperative care are crucial. The aim of this study is to assess the prognostic value of body composition for postoperative complications after laparoscopic and open colorectal surgery.
View Article and Find Full Text PDFDue to the low contrast of abdominal CT (Computer Tomography) images and the similar color and shape of the liver to other organs such as the spleen, stomach, and kidneys, liver segmentation presents significant challenges. Additionally, 2D CT images obtained from different angles (such as sagittal, coronal, and transverse planes) increase the diversity of liver morphology and the complexity of segmentation. To address these issues, this paper proposes a Detail Enhanced Convolution (DE Conv) to improve liver feature learning and thereby enhance liver segmentation performance.
View Article and Find Full Text PDFTechnical Pearls for Breast Reconstruction in Low BMI Asian Women With the Profunda Artery Perforator Flap.
Microsurgery
January 2025
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
Background: The deep inferior epigastric perforator (DIEP) flap is currently the gold standard for autologous breast reconstruction. In cases where the DIEP is contraindicated, the profunda artery perforator (PAP) flap is now the preferred second-line option in our institution. The PAP flap poses unique challenges to the reconstructive surgeon, especially in Asian women with low body mass index (BMI).
View Article and Find Full Text PDFNavigating Through Innovation in Elderly's Health: A Scoping Review of Digital Health Interventions.
Public Health Rev
December 2024
Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
Objectives: Comprehensively map and summarize digital health initiatives for the elderly and caregivers.
Methods: Scoping review between April and May 2022 based on Joanna Briggs methodology. Databases used included PubMed, Cochrane Library, CINAHL Plus, and Web of Science, along with grey literature and hand searches.
Multipocket synergy towards high thermoelectric performance in topological semimetal TaAs.
Nat Commun
January 2025
Max Planck Institute for Chemical Physics of Solids, Nöthnitzer Str. 40, Dresden, Germany.
Charge-carrier compensation in topological semimetals amplifies the Nernst signal and simultaneously degrades the Seebeck coefficient. In this study, we report the simultaneous achievement of both a large Nernst signal and an unsaturating magneto-Seebeck coefficient in a topological nodal-line semimetal TaAs single crystal. The unique dual-high transverse and longitudinal thermopowers are attributed to multipocket synergy effects: the combination of a strong phonon-drag effect and the two overlapping highly dispersive conduction and valence bands with electron-hole compensation and high mobility, promising a large Nernst effect; the third Dirac band causes a large magneto-Seebeck effect.
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!