European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 154, Issue 1 , Pages 16-19, January 2011

Abdominal surgical incisions and perioperative morbidity among morbidly obese women undergoing cesarean delivery☆

  • Jason Bell

      Affiliations

    • Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, GA, USA
    • Department of Obstetrics & Gynecology, University of Michigan School of Medicine, Ann Arbor, MI, USA
    • ,
  • Susan Bell

      Affiliations

    • Division of Health Promotion and Risk Reduction, School of Nursing, University of Michigan, Ann Arbor, MI, USA
    • ,
  • Anjel Vahratian

      Affiliations

    • Department of Obstetrics & Gynecology, University of Michigan School of Medicine, Ann Arbor, MI, USA
    • ,
  • Awoniyi O. Awonuga

      Affiliations

    • Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta, GA, USA
    • Division of Reproductive Endocrinology & Infertility, Wayne State University School of Medicine, Detroit, MI, USA
    • Corresponding Author InformationCorresponding author at: Division of Reproductive Endocrinology & Infertility, Wayne State University School of Medicine, 3800 Woodward Avenue, Suite 206, Detroit, MI 48201, USA. Tel.: +1 347 254 5772; fax: +1 313 993 4534.

Received 6 April 2010; received in revised form 4 July 2010; accepted 25 July 2010. published online 20 August 2010.

Abstract 

Objective

To test the hypothesis that there is no difference in perioperative morbidity and the type of uterine incisions between vertical skin incisions (VSI) and low transverse skin incisions (LTSI) at the time of cesarean delivery in morbidly obese women.

Study design

Retrospective cohort study of morbidly obese women (BMI>35kg/m2) who underwent cesarean delivery between June 2004 and December 2006.

Results

During the study, 424 morbidly obese women underwent cesarean section. Patients with VSI were older (31.0±6.2 years vs. 26.7±5.8 years), heavier (48.2±9.1kg/m2 vs. 41.7±6.7kg/m2), and more likely to have a classical than a low transverse uterine incision (65.9% vs. 7.3%), p<0.001. After controlling for confounders, women with VSI did not have an increase in perioperative morbidity, but underwent more vertical uterine incisions (adjusted odds ratio=18.49, 95% CI: 6.44, 53.07).

Conclusion

VSI and LTSI are safe in morbidly obese patients undergoing cesarean section, but there is a tendency for increased vertical uterine incisions in those who underwent VSI.

Keywords: Pregnancy, Morbid obesity, Cesarean delivery, Classical uterine incision, Vertical skin incision

 

☆ This study was a poster presentation at ACOG's 57th Annual Clinical Meeting, May 2–6, 2009.

PII: S0301-2115(10)00377-5

doi:10.1016/j.ejogrb.2010.07.043

European Journal of Obstetrics & Gynecology and Reproductive Biology
Volume 154, Issue 1 , Pages 16-19, January 2011

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