Risks Associated With Arrest of Descent Cesarean Deliveries [28K]. (May 2020)

• Record Type: Journal Article
• Authors: Mokhtari, Neggin; Kawakita, Tetsuya; Haddad, Andrew; Gold, Stacey; Iqbal, Sara Naeem
• Is Part Of: Obstetrics and gynecology. Volume 135(2020)Supplement 1
• Publication Date: 2020-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000664508.24999.9e
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Cesarean deliveries in laboring women are considered to have higher rates of complications compared to cesarean deliveries for other indications. We sought to evaluate if cesarean delivery for arrest of descent poses more maternal morbidity than other cesarean section indications. METHODS: We conducted a retrospective cohort study of women undergoing cesarean delivery from January 2016 to June 2018 at a single hospital. Chart review was performed to evaluate the primary indication for cesarean delivery. Maternal morbidity outcomes analyzed were blood transfusions, deep and superficial incisional surgical site infection (SSI) and postpartum endometritis. Multivariable logistic regression was performed to calculate adjusted odds ratios with 95% confidence intervals. IRB approval: STUDY00000045. RESULTS: A total of 2, 957 women underwent a cesarean section, of which 165 (5.6%) had a cesarean section for arrest of descent. Women who had arrest of descent cesarean deliveries were more likely to experience SSI (8.5 vs. 2.9%, (aOR 4.48 [95% CI 2.41-8.31]) and postpartum endometritis (6.1% vs. 1.4%, (aOR 5.28 [95% CI 2.50-11.15]) compared to women who had cesarean deliveries due to other indications. There was not an increased risk of blood transfusion between the two groups (7.9% vs. 7. 6%, (aOR 1.34 [95% CI 0.74-2.43]). CONCLUSION: No statistical difference in blood transfusion was seen between the arrest of descent group and the control group. The rates of SSI and postpartum endometritis were higher in those with arrest of descent cesarean deliveries compared to other indications for cesarean delivery. Higher vigilance in the postpartum period for infection would be prudent in this population.