Maternal and Neonatal Outcomes of Repeated Cesarean Delivery: A Comparison between Transverse and Vertical Skin Incision

Abstract

Objective:      To compare maternal and neonatal outcomes in women who had repeated cesarean section between transverse and vertical skin incision.

Material and methods:          This comparative study was conducted from April 2014 until July 2015 at Rajavithi Hospital. Patients were recruited from women who had planned and undergone repeated cesarean delivery both scheduled and in emergency conditions. Women who enrolled in this study were having single pregnancy, without classical cesarean section, previous intra-abdominal surgery from other indication, and HIV infection backgrounds. Subjects were divided into two groups, transverse and vertical skin incisions. Data was collected from antenatal care records, anesthetic notes, operative notes and the research record forms.

Results:          According to the inclusion and exclusion criteria, 500 subjects were selected. There were 286 and 214 subjects in the transverse and vertical skin incision groups, respectively. Incision-to-delivery interval in transverse was longer than in the vertical group by about 2 minutes (p < 0.001). The total operative time ± S.D. was 84.67±30.96 and 79.69±26.83 minutes in the transverse and vertical skin incision groups, respectively (p = 0.043). There was no statistical difference in internal organ injuries, estimated blood loss, post-operative outcomes, Apgar scores and fetal injuries.

Conclusion:    In repeated cesarean delivery, transverse skin incision illustrated more incision-to-delivery interval and total operative time than vertical skin incision, but no difference in adverse maternal and neonatal outcomes.