• Nanneli Pallasmaa, Ulla Ekblad, Ansa Aitokallio-Tallberg, Jukka Uotila, Tytti Raudaskoski, Veli-Matti Ulander, and Saija Hurme.
• Department of Obstetrics and Gynecology, Turku University Central Hospital, Turku, Finland. nanneli.pallasmaa@tyks.fi
• Acta Obstet Gynecol Scand. 2010 Jul 1;89(7):896-902.

ObjectiveTo assess the rate of maternal complications related to cesarean section (CS) and to compare morbidity between elective, emergency and crash-emergency CS. To establish risk factors associated with maternal CS morbidity.DesignA prospective multicenter cohort study.SettingTwelve delivery units in Finland.PopulationWomen delivering by CS (n = 2,496) during a 6 months period in the study hospitals.MethodsData on pregnant women, CS, and maternal recovery during the hospital stay was collected prospectively on report forms. The complication rates by different CSs were calculated, and factors associated with morbidity were analyzed by odds ratios (OR).Main Outcome MeasuresMaternal complication rates in different types of CS. The association of risk factors with morbidity.ResultsAbout 27% of women delivering by CS had complications; 10% had severe complications. The complication rate was higher in emergency CS than in elective CS, and highest in crash-emergency CS. Significant independent risk factors for maternal morbidity were emergency CS and crash-emergency CS compared to elective CS (OR 1.8; 95% confidence interval (CI) 1.5-2.2), pre-eclampsia (OR 1.5; CI 1.1-2.0), maternal obesity (OR 1.4; CI 1.1-1.8) and maternal increasing age (OR 1.1; CI 1.03-1.2 per each 5 years).ConclusionsMaternal complications are frequent in CS, and although performing CS electively reduces the occurrence of complications, the frequency is still high. The complication rate depends on the degree of emergency, and increases with maternal obesity, older age and pre-eclampsia.

56 keywords...

hide…