Maternal and neonatal outcomes of repeat cesarean delivery in women with a prior classical versus low transverse uterine incision

Tiki Bakhshi, Mark B. Landon, Yinglei Lai, Catherine Y. Spong, Dwight J. Rouse, Kenneth J. Leveno, Michael W. Varner, Steve N. Caritis, Paul J. Meis, Ronald J. Wapner, Yoram Sorokin, Menachem Miodovnik, Marshall Carpenter, Alan M. Peaceman, Mary J. O'Sullivan, Baha M. Sibai, Oded Langer, John M. Thorp, Brian M. Mercer

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

We compared maternal and neonatal outcomes following repeat cesarean delivery (CD) of women with a prior classical CD with those with a prior low transverse CD. The Maternal Fetal Medicine Units Network Cesarean Delivery Registry was used to identify women with one previous CD who underwent an elective repeat CD prior to the onset of labor at 36 weeks. Outcomes were compared between women with a previous classical CD and those with a prior low transverse CD. Of the 7936 women who met study criteria, 122 had a prior classical CD. Women with a prior classical CD had a higher rate of classical uterine incision at repeat CD (12.73% versus 0.59%; p<0.001), had longer total operative time and hospital stay, and had higher intensive care unit admission. Uterine dehiscence was more frequent in women with a prior classical CD (2.46% versus 0.27%, odds ratio 9.35, 95% confidence interval 1.76 to 31.93). After adjusting for confounding factors, there were no statistical differences in major maternal or neonatal morbidities between groups. Uterine dehiscence was present at repeat CD in 2.46% of women with a prior classical CD. However, major maternal morbidities were similar to those with a prior low transverse CD.

Original languageEnglish (US)
Pages (from-to)791-795
Number of pages5
JournalAmerican Journal of Perinatology
Volume27
Issue number10
DOIs
StatePublished - 2010

Keywords

  • Cesarean delivery
  • classical cesarean delivery
  • maternal outcomes
  • neonatal outcomes
  • prior cesarean

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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