Maternal Morbidity Associated With Cesarean Deliveries Due to Arrest of Dilation [24K]

Abstract

INTRODUCTION: It has been suggested that cesarean delivery during labor is associated with increased maternal morbidity compared with cesarean delivery without labor. We sought to examine the morbidity associated with cesarean deliveries due to arrest of dilation. METHODS: We conducted a retrospective cohort study of all women undergoing cesarean delivery from January 2016 to June 2018 at a single hospital. Each chart was reviewed to examine the primary indication for cesarean delivery. We examined maternal morbidity including chorioamnionitis, blood transfusion, superficial and deep incisional surgical site infections (SSI), and endometritis. We compared outcomes between women who had cesarean delivery due to arrest of dilation and those for other indications. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). IRB approval: STUDY00000045. RESULTS: Of 2957 women who underwent cesarean delivery, 214 (7.2%) had a cesarean delivery due to arrest of dilation. The rate of chorioamnionitis rates was significantly higher with arrest of dilation compared to other indications for cesarean delivery (13.6% vs. 3.6%, P<.01). Women that had cesarean delivery due to arrest of dilation compared to those who had other indications had similar rates of blood transfusion (7.5% vs. 7.6%; aOR 1.31 [95% CI 0.77–2.25]), SSI (4.7% vs. 3.1%; aOR 1.84 (95% CI 0.93–3.67]), and endometritis (2.8% vs. 1.6%; aOR 1.78 [95% CI 0.74–4.30], respectively). CONCLUSION: In contrast to theoretical concern, we found that postpartum complications (blood transfusion and postpartum infections) are similar between cesarean delivery due to arrest of dilation and cesarean delivery for other indications.