Cesarean delivery complications in women with morbid obesity

Yamasato, Kelly; Yoshino, Kurt; Chang, Ann; Caughey, Aaron B.; Tsai, Pai Jong

doi:10.3109/14767058.2016.1151869

Cited by 15 publications

(10 citation statements)

References 18 publications

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“…A total of 13 studies 14e26 that described 3,722,477 pregnancies (range, 112e2,176,673) were included in the metaanalysis. Of these, 8 studies 14,16,18e21,23,25 were included in the primary analysis, and 5 studies 15,17,22,24,26 were included in the subgroup analysis. BMI categories that were considered in the included studies are given in Supplementary Table 3.…”

Section: Resultsmentioning

confidence: 99%

“…Only 2 18,20 of the 8 studies that were included in the primary analysis presented data on underweight women, although all presented data on outcomes that were stratified by standard BMI, overweight, and the 3 classes of obesity. Of those that were included in subgroup analysis, 4 studies 17,22,24,26 enabled comparisons to be made between women with a BMI of 40e49.9 kg/ m 2 and those with a BMI of 50 kg/m 2 , and 2 studies 15,17 enabled comparisons to be made between women with a BMI of 50e59.9 kg/m 2 and a BMI of 60 kg/m 2 .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Maternal body mass index and pregnancy outcomes: a systematic review and metaanalysis

D’Souza

Horyn

Pavalagantharajah

et al. 2019

American Journal of Obstetrics & Gynecology MFM

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T he global prevalence of obesity (body mass index [BMI], 30 kg/m 2 ) has tripled since 1975, and it is estimated that, in 2016, >1.9 billion adults were overweight (BMI, 25e29.9 kg/m 2 ), of which >650 million adults were obese. 1 Among women giving birth in the United States in 2014, 50.4% were either overweight or obese. 2 In addition, adults with a BMI of kg/m 2 comprise the most rapidly growing class of obesity in the United States. 3 Pregnant women who are classified as overweight or obese are known to be at increased risk for adverse maternal and fetal/neonatal outcomes. 4,5 However, the increased risk of pregnancy complications with each obesity class over that for women with standard BMI has not been assessed systematically. Given the high prevalence of obesity among women of childbearing age, the importance of estimating pregnancy risk with increasing BMI categories has become more pertinent than ever. ObjectiveThe objective of this study was to metaanalyze data that compares pregnancy outcomes in women with obesity and that are stratified by obesity class, with the view to counselling women and informing preventative strategies preconceptionally and during pregnancy. MethodsThis study was conducted as part of study to scrutinize the effect of obesity on mode of delivery; the study protocol

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Maternal body mass index and pregnancy outcomes: a systematic review and metaanalysis

D’Souza

Horyn

Pavalagantharajah

et al. 2019

American Journal of Obstetrics & Gynecology MFM

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“…In probably the largest sample reported (38,229 women), wound complications occurred in 14% of women with BMI ≥ 45 kg/m 2 following cesarean delivery [25]. Wound separations in particular are seen more frequently in patients with super obesity [30].…”

Section: Wound Complicationsmentioning

confidence: 99%

“…Self-retaining retractors, unfortunately, have also not been found to reduce surgical site infection [30,82].…”

Section: Prevention Of Surgical Site Infectionsmentioning

confidence: 99%

Obesity: Unique Challenges at the Time of Cesarean Delivery

Roloff¹,

Cao²,

Okekpe³

et al. 2020

Recent Advances in Cesarean Delivery

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The obesity epidemic has touched all aspects of obstetric care, including the practice of cesarean delivery. Obesity is an independent risk factor for cesarean delivery, and the increased prevalence of obesity has contributed to the overall rise in primary cesarean delivery seen over the past few decades. Because of the frequent existence of co-morbidities such as hypertension and diabetes, obesity is a plausible contributor to rising maternal mortality. In addition, obese women who undergo both primary and repeat cesarean delivery have a higher chance to develop surgical and post-operative complications, including wound infection and thromboembolic events. Surgical complications increase steadily with increasing maternal weight. In this chapter, we will review the incidence and contributing factors that lead to cesarean delivery in obese patients, peri-operative complications, and strategies to reduce these risks in obese women undergoing cesarean delivery.

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“…6 Specifically, Vermillion et al 7 have shown that when the thickness of the subcutaneous tissue is > 3 cm the relative risk of developing wound infection reaches 2.8. Recently, Yamasato et al 8 . suggested that the rates of wound dehiscence tend to increase as the body mass index (BMI) increases.…”

Section: Introductionmentioning

confidence: 99%

The impact of subcutaneous tissue suturing at caesarean section on wound complications: a meta‐analysis

Pergialiotis

Prodromidou

Perrea

et al. 2017

BJOG

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databases together with reference lists from included studies.Selection criteria Randomised and quasi-randomised trials that investigated the impact of subcutaneous tissue suturing on wound complications following caesarean section were held eligible for inclusion. Retrospective studies and prospective nonrandomised studies were excluded from the present meta-analysis.Data collection and analysis The methodological quality of studies was assessed with the Jadad scale. Statistical meta-analysis was performed with the REVMAN 5.3 software.Main results Ten studies were finally included in our metaanalysis, which involved 3696 women delivered by caesarean section. Re-approximation of the subcutaneous tissue significantly reduced the odds of developing any type of wound Conclusions The results of our meta-analysis suggest that subcutaneous tissue closure may benefit women undergoing caesarean section. Current data in women with high body mass index remain very limited; hence, definitive conclusions are precluded for this specific group.Keywords Caesarean, complications, haematoma, seroma, subcutaneous, wound. Please cite this paper as: Pergialiotis V, Prodromidou A, Perrea DN, Doumouchtsis SK. The impact of subcutaneous tissue suturing at caesarean section on wound complications: a meta-analysis.

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Cesarean delivery complications in women with morbid obesity

Abstract: Wound complications, particularly separations, increase with BMI ≥ 50 compared to a lesser degree of morbid obesity. Skin closure techniques and self-retaining retractor use were not associated with cesarean wound complications in patients with morbid obesity.

Cited by 15 publications

References 18 publications

Maternal body mass index and pregnancy outcomes: a systematic review and metaanalysis

Maternal body mass index and pregnancy outcomes: a systematic review and metaanalysis

Obesity: Unique Challenges at the Time of Cesarean Delivery

The impact of subcutaneous tissue suturing at caesarean section on wound complications: a meta‐analysis

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