000 | 03890nam a22003617a 4500 | ||
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008 | 191010s20192019 xxu||||| |||| 00| 0 eng d | ||
022 | _a1476-4954 | ||
024 | _a10.1080/14767058.2019.1663819 [doi] | ||
040 | _aOvid MEDLINE(R) | ||
099 | _a31480918 | ||
245 | _aMaternal outcomes according to cesarean uterine incision between 23 and 27 weeks' gestation. | ||
251 | _aJournal of Maternal-Fetal & Neonatal Medicine. :1-5, 2019 Sep 16 | ||
252 | _aJ Matern Fetal Neonatal Med. :1-5, 2019 Sep 16 | ||
253 | _aThe journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians | ||
260 | _c2019 | ||
260 | _fFY2020 | ||
265 | _saheadofprint | ||
266 | _d2019-10-10 | ||
501 | _aAvailable online through MWHC library: 2013 to the present | ||
520 | _aObjective: Cesarean delivery between 23 and 27 weeks' gestation is a risk factor for performing classical and inverted T uterine incisions. When attempting cesarean delivery via a low transverse incision at a very preterm gestational age, having difficulty in delivery of the fetus may require conversion to an inverted T-incision. We sought to examine maternal short-term outcomes according to the type of attempted uterine incisions in preterm deliveries. Study design: This was a multihospital retrospective cohort study of women undergoing cesarean delivery between 23 0/7 and 27 6/7 week' gestation from 2005 through 2014. Cases were classified as attempting low transverse incision if the uterine incision was a low transverse or an inverted T incision. Composite maternal outcome (postpartum hemorrhage, transfusion, endometritis, sepsis, wound infection, deep venous thrombosis/pulmonary embolism, hysterectomy, respiratory complications, and intensive care unit admission) was compared between cases where a low transverse incision was attempted and those with a classical uterine incision. We also examined operative time and Apgar score at 5 minutes. Multivariable logistic regression or linear regression was used to obtain adjusted p-value or adjusted odds ratios (aOR) with 95% confidence interval (95%CI), controlling for maternal age, gestational age, body mass index (kg/m2), and preterm premature rupture of membranes. Results: Of 311 women undergoing cesarean delivery between 23 0/7 and 27 6/7 week' gestation, attempting low transverse incision occurred in 127 (41%). Of these, conversion to an inverted T or J uterine incision occurred in 14 (11%). There was no difference in the composite outcome between cases with attempting low transverse incision and those with classical incision (17.3 versus 23.4%, respectively; aOR 0.58 [95%CI 0.30-1.11]). Cases in which a low transverse uterine incision was attempted had shorter median operative time (46 versus 55 minutes; adjusted p-value < 0.01). No differences were seen in the Apgar score at 5 minutes (adjusted p-value = .81). Conclusion: The incidence of conversion from a low transverse to an inverted T uterine incision in very preterm cesarean deliveries was low. Attempting a low transverse compared to a classical uterine incision was associated with similar odds of the primary outcome and shorter operative time. | ||
546 | _aEnglish | ||
650 | _aIN PROCESS -- NOT YET INDEXED | ||
651 | _aMedStar Health Research Institute | ||
651 | _aMedStar Washington Hospital Center | ||
656 | _aObstetrics and Gynecology/Maternal-Fetal Medicine | ||
657 | _aJournal Article | ||
700 | _aDhillon, Namisha K | ||
700 | _aHuang, Jim C | ||
700 | _aKawakita, Tetsuya | ||
790 | _aDhillon NK, Huang JCC, Kawakita T | ||
856 |
_uhttps://dx.doi.org/10.1080/14767058.2019.1663819 _zhttps://dx.doi.org/10.1080/14767058.2019.1663819 |
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942 |
_cART _dArticle |
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999 |
_c4580 _d4580 |