Transverse Abdominal, Uterine Incisions Are Best For Obese Women Having Cesarean Delivery.

2001 APR 12 - (NewsRx.com & NewsRx.net) -- by Susan Hasty, staff medical writer - Transverse abdominal or uterine incisions have fewer complications for babies delivered by cesarean section and their obese mothers, say researchers.

In fact, transverse incisions in cesarean deliveries are better for women and their babies, regardless of the mother's weight, said A.M. D'Heureux-Jones and colleagues at the University of Maryland School of Medicine, Baltimore.

D'Heureux-Jones and associates reviewed the records of 71 patients - 45 of whom met the criteria for obesity ([greater than]200 lb) - whose babies were delivered by cesarean section at the university's hospital. The researchers analyzed the types of incisions and the impact on time of delivery (skin-baby), estimated blood loss (EBL), wound infections, and metritis between the obese and normal weight mothers.

The combination abdominal Pfannenstiel (P) low transverse (L) uterine incision was used most often in both the obese (64%, n=29) and nonobese mothers (88%, n=23), and this incision was associated with faster skin-baby times (9.4 [+ or -] 0.8 minutes and 9.9 [+ or -] 1.1 minutes, respectively, p[less than]0.05).

The classical (C) uterine incision was associated with higher rates of prematurity and neonatal intensive care unit admissions in both obese and nonobese mothers ("Incision choice for cesarean delivery in obese patients: Experience in a university hospital," Obstetrics & Gynecology, April 2001;97(4 Suppl 1):S62-S63).

The classical uterine incision also took longer in obese patients (16.4 [+ or -] 2.8 ...