Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study

ObjectiveEstimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes.DesignCase–control study.SettingSites in Australia and New Zealand with at least 50 births per year.ParticipantsCases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls.MethodsData were collected using the Australasian Maternity Outcomes Surveillance System.Primary and secondary outcome measuresIncidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death).ResultsThe incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs <30: 19.1, 95% CI 4.6 to 80.3) and current multiple birth (AOR: 6.1, 95% CI 1.1 to 34.1). In multiparous women, independent risk factors were prior CS (AOR ≥2 prior sections vs 0: 13.8, 95% CI 7.4 to 26.1) and current placenta praevia (AOR: 36.3, 95% CI 14.0 to 93.7). There were two maternal deaths (case fatality rate 0.7%).Women with placenta accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation.

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Risk Factors for Urological Complications Associated with Caesarean Section—A Case-Control Study

Medicina ◽

10.3390/medicina58010123 ◽

2022 ◽

Vol 58 (1) ◽

pp. 123

Author(s):

Viorel Dragos Radu ◽

Anda Ioana Pristavu ◽

Angela Vinturache ◽

Pavel Onofrei ◽

Demetra Gabriela Socolov ◽

...

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Case Control Study ◽

Placenta Accreta ◽

Case Control ◽

Case Group ◽

Urologic Complications ◽

Caesarean Hysterectomy ◽

Urological Injuries ◽

Control Study

Background and Objectives: Acute urologic complications, including bladder and/or ureteric injury, are rare but known events occurring at the time of caesarean section (CS). Delayed or inadequate management is associated with increased morbidity and poor long-term outcomes. We conducted this study to identify the risk factors for urologic injuries at CS in order to inform obstetricians and patients of the risks and allow management planning to mitigate these risks. Materials and Methods: We reviewed all cases of urological injuries that occurred at CS surgeries in a tertiary university centre over a period of four years, from January 2016 to December 2019. To assess the risk factors of urologic injuries, a case-control study of women undergoing caesarean delivery was designed, matched 1:3 to randomly selected women who had an uncomplicated CS. Electronic medical records and operative reports were reviewed for socio-demographic and clinical information. Descriptive and univariate analyses were used to characterize the study population and identify the risk factors for urologic complications. Results: There were 36 patients with urologic complications out of 14,340 CS patients, with an incidence of 0.25%. The patients in the case group were older, had a lower gestational age at time of delivery and their newborns had a lower birth weight. Prior CS was more prevalent among the study group (88.2 vs. 66.7%), as was the incidence of placenta accreta and central praevia. In comparison with the control group, the intraoperative blood loss was higher in the case group, although there was no difference among the two groups regarding the type of surgery (emergency vs. elective), uterine rupture, or other obstetrical indications for CS. Prior CS and caesarean hysterectomy were risk factors for urologic injuries at CS. Conclusions: The major risk factor for urological injuries at the time of CS surgery is prior CS. Among patients with previous CS, those who undergo caesarean hysterectomy for placenta previa central and placenta accreta are at higher risk of surgical haemostasis and complex urologic injuries involving the bladder and the ureters.

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Risk Factors for Wound Infection Following Caesarean Section: A Case Control Study from Sir Salimullah Medical College & Mitford Hospital in Dhaka, Bangladesh

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2019.96088 ◽

2019 ◽

Vol 09 (06) ◽

pp. 904-913

Author(s):

Farhana Israt Jahan ◽

Ferdousi Begum ◽

Farzana Islam ◽

Shahana Pervin ◽

Annekathryn Goodman

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Wound Infection ◽

Case Control Study ◽

Case Control ◽

Medical College ◽

Control Study

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Risk Factors of Meconium-Stained Amniotic Fluid in Term Pregnancy - A Case Control Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/158 ◽

2021 ◽

Vol 8 (13) ◽

pp. 806-810

Author(s):

Asha P.S ◽

Sujatha T.L.

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Amniotic Fluid ◽

Case Control Study ◽

Significant Risk ◽

Case Control ◽

Inclusion Criteria ◽

Term Pregnancy ◽

Meconium Stained Amniotic Fluid ◽

Control Study

BACKGROUND Meconium stained amniotic fluid is a significant contributor to perinatal and neonatal morbidity and mortality. The study was conducted to determine the risk factors of meconium stained amniotic fluid in term pregnancy. METHODS This study is a prospective case control study done in a tertiary care hospital in South India over a period of one year. 100 women with meconium stained amniotic fluid detected at any time during the course of labour, prior to it or meconium detected in hind waters were enrolled in the study group. The inclusion criteria were term pregnancy, cephalic presentation and singleton pregnancy. 200 women who satisfied the same set of inclusion criteria with clear amniotic fluid, selected on random basis were taken as controls. A standardised pretested proforma was used for data collection. RESULTS In the study, incidence of grade 1, grade 2 and grade 3 meconium were 31 %, 42 % and 27 % respectively. 83 % of cases were in the 20 – 24 year age group and advanced maternal age was not a risk factor in the study. Primiparity (86 % cases vs. 47 % controls) and advanced gestational age (56 % cases and 33 % controls) were significant risk factors. Maternal obesity, socioeconomic status and treatment for infertility were not significant risk factors. Among medical disorders, gestational diabetes mellitus (21 % cases vs. 5 % controls), gestational hypertension (12 % vs. 3.5 %) and hypothyroidism (13 % cases vs. 4.5 % controls) showed statistical significance. Oligoamnios (9 % vs. 1 %), fetal growth restriction (13 % vs. 4.5 %) and maternal infection (12 % vs. 2 %) were significant risk factors. Induced labour and prolonged labour were the significant intrapartum risk factors. Caesarean section rates were nearly doubled in cases (40 %) compared to controls (21.5 %). Babies born to mothers with meconium stained amniotic fluid had low Apgar scores at birth (25 %) and increased neonatal intensive care unit (NICU) admission. CONCLUSIONS Meconium stained amniotic fluid is associated with increased rates of maternal morbidity due to higher rates of operative deliveries and increased incidence of perinatal asphyxia, perinatal morbidity and mortality. Meticulous antenatal care and early identification of risk factors help in reducing the incidence of meconium stained amniotic fluid and preventing adverse maternal and neonatal outcome. KEYWORDS Risk Factors, Meconium, Amniotic Fluid, Term Pregnancy, Caesarean Section, Perinatal Outcome

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Risk Factors for Neonatal Sepsis: A Retrospective Case-Control Study among Neonates Who Were Delivered by Caesarean Section at the Trauma and Specialist Hospital, Winneba, Ghana

BioMed Research International ◽

10.1155/2018/6153501 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Peter Adatara ◽

Agani Afaya ◽

Solomon Mohammed Salia ◽

Richard Adongo Afaya ◽

Anthony K. Kuug ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Caesarean Section ◽

Neonatal Sepsis ◽

Case Control Study ◽

Case Control ◽

Multivariate Logistic Regression ◽

Retrospective Case ◽

Chi Square Analysis ◽

Control Study

The third Sustainable Development Goal (SDG) for child health, which targets ending preventable deaths of neonates and children under five years of age by 2030, may not be met without substantial reduction of neonatal sepsis-specific mortality in developing countries. This study aimed at assessing the prevalence and risk factors for neonatal sepsis among neonates who were delivered via caesarean section. A retrospective case-control study was conducted among neonates who were delivered via caesarean section at the Trauma and Specialist Hospital, Winneba, Ghana. Data collection lasted for 4 weeks. The extracted data were double-entered using Epidata software version 3.1 to address discrepancies of data entry. Descriptive statistics such as frequencies and percentages of neonatal characteristics were generated from the data. Both univariate and multivariate logistic regression were used to determine associations between neonatal sepsis and neonatal characteristics with odds ratios, 95% confidence intervals, and p values calculated using variables that showed significant association (p<0.05) in the chi-square analysis for the multivariate logistic regression. A total of 383 neonates were recruited; 67 (17.5%) had sepsis (cases). The neonatal risk factors associated with sepsis were birth weight (χ2=6.64, p=0.036), neonatal age (χ2=38.31, p<0.001), meconium passed (χ2=12.95, p<0.001), reason for CS (χ2=24.27, p<0.001), and the duration of stay on admission (χ2=36.69, p<0.001). Neonatal sepsis poses a serious threat to the survival of the newborn as the current study uncovered 6.0% deaths among sepsis cases. The findings of this study highlight the need for routine assessment of neonates in order to identify risk factors for neonatal sepsis and to curb the disease burden on neonatal mortality.

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Uterine sutures at prior caesarean section and placenta accreta in subsequent pregnancy: a case-control study

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/1471-0528.12717 ◽

2014 ◽

Vol 121 (7) ◽

pp. 866-875 ◽

Cited By ~ 21

Author(s):

S Sumigama ◽

C Sugiyama ◽

T Kotani ◽

H Hayakawa ◽

A Inoue ◽

...

Keyword(s):

Caesarean Section ◽

Case Control Study ◽

Placenta Accreta ◽

Case Control ◽

Subsequent Pregnancy ◽

Control Study

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Maternal caesarean section infection (MACSI) in Sierra Leone: a case–control study

Epidemiology and Infection ◽

10.1017/s0950268820000370 ◽

2020 ◽

Vol 148 ◽

Cited By ~ 7

Author(s):

F. Di Gennaro ◽

C. Marotta ◽

L. Pisani ◽

N. Veronese ◽

V. Pisani ◽

...

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Sierra Leone ◽

Case Control Study ◽

Multivariable Analysis ◽

Maternity Hospital ◽

Case Control ◽

Maternal Deaths ◽

Low Education ◽

Control Study

Abstract Sierra Leone is the country with highest maternal mortality and infections are the underlying cause in 11% of maternal deaths, but the real burden remains unknown. This study aims to determine the incidence and risk factors of surgical site infection (SSI) post-caesarean section (CS) in women admitted to Princess Christian Maternity Hospital (PCMH) in Freetown, Sierra Leone. A prospective case–control (1:3 ratio) study was implemented from 1 May 2018 to 30 April 2019 and 11 women presenting with suspected or confirmed infection post-CS were screened for inclusion as a case. For each case, three patients undergoing CS on the same day and admitted to the same ward, but not presenting with SSI, were selected as controls. The post-CS infection rate was 10.9%. Two hundred and fifty-four clinically confirmed cases were enrolled and matched with 762 control patients. By multivariable analysis, the risk factors for SSI were: being single (odds ratio (OR) 1.48, 95% confidence interval (CI) 1.36–1.66), low education level (OR 1.68, 95% CI 1.55–1.84), previous CS (OR 1.27, 95% CI 1.10–1.52), presenting with premature membranes rupture (OR 1.49, 95% CI 1.18–1.88), a long decision–incision time (OR 2.08, 95% CI 1.74–2.24) and a high missing post-CS antibiotic doses rate (OR 2.52, 95% CI 2.10–2.85).

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