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Accidental fetal lacerations during cesarean delivery: experience in an Italian level III University hospital

Dessole, Salvatore and Cosmi, Erich and Balata, Antonio and Uras, Luisa and Caserta, Donatella and Capobianco, Giampiero and Ambrosini, Guido (2004) Accidental fetal lacerations during cesarean delivery: experience in an Italian level III University hospital. American Journal of Obstetrics and Gynecology, Vol. 191 (5), p. 1673-1677. ISSN 0002-9378. Article.

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DOI: 10.1016/j.ajog.2004.03.030

Abstract

Objective The purpose of this study was to investigate the incidence, type, location, and risk factors of accidental fetal lacerations during cesarean delivery Study design Total deliveries, cesarean deliveries, and neonatal records for documented accidental fetal lacerations were reviewed retrospectively in our level III university hospital. The gestational age, the presenting part of the fetus, the cesarean delivery indication, the type of incision, and the surgeon who performed the procedure were recorded. Cesarean deliveries were divided into scheduled, unscheduled, and emergency procedures. Fetal lacerations were divided into mild, moderate, and severe. Neonatal follow-up examinations regarding laceration sequelae were available for 6 months. Results Of 14926 deliveries, 3108 women were delivered by cesarean birth (20.82%). Neonatal records documented 97 accidental fetal lacerations. Of these accidental lacerations, 94 were mild; 2 were moderate, and 1 was severe. The overall rate of accidental fetal laceration per cesarean delivery was 3.12%; the accidental laceration rate in the cohort of fetuses was 2.46%. The crude odds ratios were 0.34 for scheduled procedures, 0.57 for unscheduled procedures, and 1.7 for emergency procedures. The risk for fetal accidental lacerations was higher in fetuses who underwent emergency cesarean birth and lower for unscheduled and scheduled cesarean births (P < .001). Conclusion Fetal accidental laceration may occur during cesarean delivery; the incidence is significantly higher during emergency cesarean delivery compared with elective procedures. The patient should be counseled about the occurrence of fetal laceration during cesarean delivery to avoid litigation.

Item Type:Article
ID Code:2251
Status:Published
Refereed:Yes
Uncontrolled Keywords:Accidental fetal lacerations, cesarean delivery, fetus
Subjects:Area 06 - Scienze mediche > MED/40 Ginecologia e ostetricia
Divisions:001 Università di Sassari > 01 Dipartimenti > Neuroscienze, scienze materno infantili
Publisher:Mosby
ISSN:0002-9378
Copyright Holders:© 2004 Elsevier
Deposited On:18 Aug 2009 10:07

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