Evidence map›Paper›PMID 36753477›Full record

ArticlePloS one2023

Repeat low order caesarean delivery, risk factors for complications: A retrospective, longitudinal study.

Orna Reichman, Misgav Rottenstreich, Hen Y Sela, Rachel Michaelson-Cohen, Zvi Ehrlich, Reut Rotem, Sorina Grisaru-Granovsky

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Orna ReichmanFaculty of Medicine, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.ORCID 0000-0003-0809-6089
Misgav RottenstreichFaculty of Medicine, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Hen Y SelaFaculty of Medicine, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Rachel Michaelson-CohenFaculty of Medicine, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Zvi EhrlichFaculty of Medicine, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Reut RotemFaculty of Medicine, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Sorina Grisaru-GranovskyFaculty of Medicine, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Hebrew University of Jerusalem · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

One-third of cesarean deliveries (CDs) are repeat operations, of which the majority are low-order, second (CD2) and third (CD3). The study objectives were to identify risk factors for a complicated maternal CD among women undergoing a repeat low-order CD and to develop a predictive model for at-risk women. A retrospective longitudinal follow-up study was conducted in a single medical center, during 2005-2016. Women who underwent both CD2 and CD3 at the site were included. Those with placenta accreta or a caesarean hysterectomy were excluded. A composite complicated maternal CD was defined by either uterine rupture/dehiscence, blood transfusion, relaparotomy, admission to the intensive care unit or prolonged operative time >90th percentile. Data was analyzed comparing between CD2 to CD3, each woman served as her own control. Univariate analysis followed by a multivariate logistic regression modeling were performed with an OR of 95% CI defining significance. The study group comprised of 1,331 women. A complicated CD occurred in 159 (12%) vs. 226 (17%) of CD2 vs. CD3 respectively, (p<0.001). Women with a complicated CD2 were at higher risk for complications in CD3, aOR 2.3 (95% CI 1.5, 3.3). Sub-Saharan African origin and preterm delivery at CD3 were both risk factors for a complicated CD3, aOR 3.7 (95% CI 1.9, 7.3) and aOR 1.7 (95% CI 1.1, 2.7), respectively. The multivariate regression model included 1328 cases, was statistically significant, χ2(7) = 50.760, p <0.001, explained 6.3% of the variance of composite complicated maternal CD3 and correctly classified 82.9% of cases. Although a complicated CD2, Sub-Saharan African origin and preterm delivery are risk factors for maternal complications in CD3, it is hard to predict which specific women will experience complications. Sensitivity, specificity, positive and negative predictive value of a complicated CD2 for detecting complications in CD3 were 21%, 90%, 30% and 85% respectively.

Indexed as

Premature BirthCesarean SectionFemaleFollow-Up StudiesHumansInfant, NewbornLongitudinal StudiesPregnancyRetrospective StudiesRisk Factors

Identifiers

PMID36753477
PMCPMC9907808
OpenAlexW4319460189

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.