Abdominal surgical incisions and perioperative morbidity among morbidly obese women undergoing cesarean delivery

Objective

To test the hypothesis that there is no difference in perioperative morbidity and the type of uterine incisions between vertical skin incisions (VSI) and low transverse skin incisions (LTSI) at the time of cesarean delivery in morbidly obese women.

Study design

Retrospective cohort study of morbidly obese women (BMI > 35 kg/m²) who underwent cesarean delivery between June 2004 and December 2006.

Results

During the study, 424 morbidly obese women underwent cesarean section. Patients with VSI were older (31.0 ± 6.2 years vs. 26.7 ± 5.8 years), heavier (48.2 ± 9.1 kg/m² vs. 41.7 ± 6.7 kg/m²), and more likely to have a classical than a low transverse uterine incision (65.9% vs. 7.3%), p < 0.001. After controlling for confounders, women with VSI did not have an increase in perioperative morbidity, but underwent more vertical uterine incisions (adjusted odds ratio = 18.49, 95% CI: 6.44, 53.07).

Conclusion

VSI and LTSI are safe in morbidly obese patients undergoing cesarean section, but there is a tendency for increased vertical uterine incisions in those who underwent VSI.