Second Stage Cesarean Deliveries: Does Amount of Pushing and Fetal Station Increase Maternal Morbidity? [29K]. (May 2020)

• Record Type: Journal Article
• Authors: Mokhtari, Neggin; Gold, Stacey; Kawakita, Tetsuya
• 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.0000664512.93052.0d
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Cesarean deliveries due to arrest of descent are considered to have more complications compared to cesarean deliveries due to other indications. We sought to examine if duration of pushing and fetal station at time of cesarean delivery increases rates of maternal morbidity. METHODS: A retrospective cohort study of all women undergoing cesarean delivery from January 2016 to June 2018 at a single hospital was performed. We compared the risks of blood transfusion, superficial and deep incisional surgical site infection (SSI) and postpartum endometritis according to hours of pushing in the second stage (2-4 hours vs. 5 or more hours) and fetal station (⩽0 vs. +1 to +5) at time of cesarean delivery. Multivariable logistic regression was performed to calculate adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). IRB approval: STUDY00000045. RESULTS: Of 165 (5.6%) who had arrest of descent, 124 (75%) women were pushing for 2-4 hours, while 41 (25%) pushed for five or more hours at time of their surgery. Women who pushed at least 5 hours compared to those who pushed for 2-4 hours had similar rates of blood transfusion, SSI, and endometritis (aOR 0.23 [95% CI 0.03, 1.83], aOR 1.28 [95% CI 0.37, 4.40], aOR 1.25 [0.31, 5.13], respectively). Women who had fetal station of +1 to+5 compared to those who had fetal station of ⩽0 had similar rates of blood transfusion, SSI, or endometritis. CONCLUSION: Increased length of time of pushing and lower fetal station in the second stage of labor did not significantly increase the rate of maternal complications.