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Prolonged operative time of cesarean is a risk marker for subsequent cesarean maternal complications. | LitMetric

AI Article Synopsis

  • Prolonged cesarean operative time (beyond 60 minutes) is linked to higher chances of maternal complications in future cesarean deliveries.
  • A study analyzed data from women who had two cesarean deliveries between 2005 and 2019, finding that 7% experienced prolonged operative times.
  • The results highlighted significant associations between prolonged OT and complications like heavy blood loss, the need for blood transfusions, and serious injuries during subsequent surgeries.

Article Abstract

Purpose: Prolonged cesarean operative time (OT) is a well-established proxy for post-operative maternal complications. We aimed to study whether prolonged OT may serve as a proxy for maternal complications in the subsequent cesarean delivery.

Methods: A retrospective cohort study of women who underwent cesarean delivery between 2005 and 2019. Parturients who had two subsequent cesarean deliveries were included and those with Placenta Accreta Syndrome (PAS) were excluded. Prolonged operative time was defined as the duration of cesarean delivery above 60 min. Univariate analyses were followed by multivariate analysis (adjusted Odds Ratio (aORs); [95% Confidence Interval]).

Results: A total of 5163 women met the inclusion and exclusion criteria of which 360 (7%) had prolonged operative time. Prolonged operative time of a cesarean section in the index pregnancy was significantly associated in the subsequent cesarean delivery with the following: Prolonged operative time, intra-operative blood loss > 1000 ml, postpartum hemorrhage, blood products transfusion, injuries to the urinary system in the subsequent delivery, and hysterectomy. Multivariate analysis revealed that prolonged OT in the index delivery was associated with composite adverse maternal outcome (aOR 1.46 [1.09-1.95]; P = 0.01) and blood products transfusion (aOR 2.93 [1.90-4.52]; P < 0.01) in the subsequent delivery.

Conclusion: Prolonged operative may serve as a proxy for adverse maternal outcomes, mostly blood products transfusion, in the subsequent cesarean delivery among women undergoing repeat cesarean delivery.

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Source
http://dx.doi.org/10.1007/s00404-022-06575-4DOI Listing

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