Risk factors associated with accidental fetal skin lacerations during cesarean delivery. Issue 1 (2nd June 2022)

• Record Type: Journal Article
• Authors: Har‐Shai, Lior; Kreichman, Rita; Kedar, Reuven; Osovsky, Micky; Chen, Rony; Lavi, Idit; Metanes, Issa; Segal, Miriam; Ofek, Sar‐El; Mattar, Samar; Hassan, Samer; Kramer, Aviv; Bryzgalin, Leonid; Ad‐El, Dean; Sagi‐Dain, Lena; Lavie, Ofer; Har‐Shai, Yaron
• Is Part Of: International journal of gynaecology and obstetrics. Volume 160:Issue 1(2023)
• Page Start: 131
• Page End: 135
• Publication Date: 2022-06-02
• Subjects: accidental fetal skin lacerations -- cesarean section -- meconium -- premature rupture of membranes -- risk factors; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.14273
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To identify risk factors associated with accidental fetal skin lacerations (AFL) during cesarean section (CS). Methods: This retrospective cohort study was obtained from the registry of two large medical centers between 2014 and 2019. The study group comprised all newborns identified with AFL. The rates of various potential risk factors were compared between the study group and a group of CS at which no AFL had occurred (the control group). Results: Of the 14 666 CS deliveries, 48 cases of AFL (0.33%) were documented, 52% of these following urgent CS. Compared with the control group ( n = 14 618), the only risk factors associated with AFL were premature rupture of membranes (PROM) (odds ratio [OR] 5.38, 95% convidence interval [CI] 2.97–9.74) and meconium‐stained amniotic fluid (OR 6.50, 95% CI 2.55–16.54). In subgroup analysis by CS urgency, no significance for these factors was noted in elective CS group; but higher rates of both PROM and meconium‐stained amniotic fluid were noted in the AFL during urgent CS (OR 14.23, 95% CI 6.30–32.16 and OR 15.36, (95% CI 5.65–41.75, respectively). Conclusions: During urgent CS, the surgeon should bear in mind that the presence of PROM or meconium‐stained amniotic fluid should prompt extra care and application of preventive measures to decrease the rates of AFL. Synopsis: Premature rupture of membranes and meconium‐stained amniotic fluid increase the risk for accidental fetal lacerations during urgent cesarean delivery.