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Maternal complications in settings where two-thirds of extremely preterm births are delivered by cesarean section
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna. Ctr Clin Res Dalarna, Falun, Sweden..
Skelleftea Hosp, Dept Obstet & Gynecol, Skelleftea, Sweden..
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2017 (English)In: Journal of Perinatal Medicine, ISSN 0300-5577, E-ISSN 1619-3997, Vol. 45, no 1, 121-127 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate the maternal complications associated with cesarean section (CS) in the extremely preterm period according to the gestational week (GW) and to indication of delivery. Study design: This is a retrospective case-referent study with a review of medical records of women who delivered at 22-27 weeks of gestation (n = 647) at two level III units in Sweden. For abdominal delivery, gestational length was stratified into 22-24 (n = 105) and 25-27 (n = 301) weeks. For comparison, data on women who underwent a CS at term were identified in a register-based database. Results: The rate of CS in extremely preterm births was 62.8%. There was no difference in the complication rates, but types of incisions other than the low transverse incision were required more often at 22-24 (18.1%) weeks than at 25-27 GWs (9.6%) (P = 0.02). Major maternal complications occurred in 6.6% compared with 2.1% in the extremely preterm and term CS, respectively (P < 0.01). A maternal indication of extremely preterm CS increased the risk of complications. Conclusions: Almost two-thirds of the births at 22-27 GWs had an abdominal delivery. No increase in short-term morbidity was observed at 22-24 weeks compared to 25-27 weeks. CS performed extremely preterm had more major complications recorded than cesarean at term. The complications are driven by the underlying maternal condition.

Place, publisher, year, edition, pages
2017. Vol. 45, no 1, 121-127 p.
Keyword [en]
Cesarean section, extremely preterm birth, post-operative complications, pregnancy complications
National Category
Pediatrics Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-317691DOI: 10.1515/jpm-2016-0198ISI: 000393201100016PubMedID: 27768584OAI: oai:DiVA.org:uu-317691DiVA: diva2:1082679
Funder
Swedish Research Council
Available from: 2017-03-17 Created: 2017-03-17 Last updated: 2017-03-17Bibliographically approved

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Hesselman, SusanneJonsson, MariaRåssjö, Eva-BrittaHögberg, Ulf
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