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Erschienen in:
01.04.2011 | Materno-fetal Medicine
Timing and risk factors of maternal complications of cesarean section
Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2011
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Objective
To investigate the timing and risk factors of maternal complications of cesarean section (CS).
Methods
Review of the files of all women who underwent CS at a tertiary medical center between September 2007 and December 2008 yielded 100 patients with postpartum complications. Their clinical and surgery-related characteristics were compared with 100 women with uncomplicated CS operated in January 2009. Complications were analyzed by prevalence and time of occurrence.
Results
The only between-group difference in background factors was a higher rate of obesity (BMI > 30) in the controls. The complication rate was 5.7%. The most common complication was endomyometritis (3.6%), followed by wound infection (1.8%) and wound hematoma (1.2%). In most cases, endomyometritis was diagnosed on postoperative days 2–3 and wound complications on days 2–5; 7 of the 9 readmissions occurred on postoperative days 5–6. On multivariate analysis, significant independent predictors of postoperative complications were surgeon experience (OR = 2.4, 95% CI 1.2–4.8) and intra-partum CS (OR = 2.1, 95% CI 1.1–4.3).
Conclusion
Cesarean section performed by a resident or during active labor is associated with an increased risk of postpartum complications. Medical teams should be alert to morbidity in women at risk, particularly during the first 4 days after CS.