BackgroundTissue adhesives are now routinely used for skin closure in various surgeries. This study aimed to evaluate the safety and efficacy of n-butyl-2-cyanoacrylate (NBCA) tissue adhesive in cesarean delivery by comparing it with the safety and efficacy of subcuticular suture closure.Methods and findingsA retrospective chart review was undertaken of all patients who underwent cesarean delivery via Pfannenstiel skin incision. During the study period, a total of 209 patients had NBCA (Histoacryl®) closure and 208 patients had suture closure. Wound complications and Vancouver scar scale (VSS) scores were compared between the 2 groups.ResultsThere were no significant differences between the two groups in indications for cesarean deliveries or number of previous cesarean deliveries. Incidences of wound disruption and infection were also similar between the two closure groups (p = 0.322 and 0.997, respectively). The rate of wound complications was 3.4% in the NBCA group and 5.3% in the suture group. All complications healed uneventfully with topical antibiotics or closure strips. VSS scores at 6–8 weeks after operation were not significantly different between the two groups (p = 0.858). These results were corroborated by propensity score-matching analysis.ConclusionsNBCA may be a useful skin closure of Pfannenstiel skin incisions after cesarean delivery.

ObjectiveTo evaluate the predictive factors associated with the success of medical abortion by misoprostol monotherapy within 24 hours in the first trimester of pregnancy.MethodsThe records of 228 women with miscarriage up to 11 weeks of gestational age who underwent medical abortion by intravaginal misoprostol monotherapy were reviewed. Success of abortion was defined as complete expulsion of the conceptus without the need for surgical intervention. Outcomes of interest were success of abortion within 24 hours following administration of misoprostol.ResultsAmong 222 women who continued the process of medical abortion for 24 hours, 209 (94.1%) had a successfully completed abortion. Multivariate logistic regression showed that serum β-human chorionic gonadotropin (β-hCG) above 40,000 mIU/mL is significantly associated with failed medical abortion within 24 hours (odds ratio [OR], 7.13; 95% confidence interval [CI], 1.60–37.32; P=0.011). The area under the receiver operating characteristic curve of β-hCG level associated with successful abortion within 24 hours was 0.705 (95% CI, 0.63–0.77; P=0.007). Previous vaginal delivery seems to be significantly associated with successful abortion within 24 hours on univariate analysis (P=0.037), but the association was lost in multivariate analysis.ConclusionMisoprostol monotherapy has a high success rate for first trimester abortion. Women with serum β-hCG less than 40,000 mIU/mL are likely to achieve a successful abortion within 24 hours after intravaginal administration of misoprostol.

SGA neonates in the absence of PE could potentially be identified at 15-18 weeks of pregnancy.