{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T06:27:50Z","timestamp":1750228070077,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T00:00:00Z","timestamp":1691280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to determine risk factors for prolonged surgery time of cesarean delivery (CD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study in a single tertiary university\u2013affiliated medical center (2011\u20132022). The study group consisted of all women who underwent CD that lasted &gt;90\u2009min (representing the 95th percentile of CD length in our cohort). Data were compared with CDs with an operation time of &lt;90\u2009min. Demographic, obstetric, and surgical characteristics, as well as indications for surgery and urgency (in labor vs. elective surgery), were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, during the study period, 31\u2009660 CDs were performed in our center. Of them, 1397 (4.4%) lasted &gt;90\u2009min.<\/jats:p><jats:p>After applying a multivariate analysis, abnormal placentation (relative risk [RR] 1.5 [95% confidence interval (CI), 1.3\u20131.8]), previous uterine scar (RR, 2.15 [95% CI, 1.5\u20133.0]), general anesthesia (RR, 3.5 [95% CI, 2.9\u20134.4]) and preterm delivery (RR, 2.06 [95% CI, 1.78\u20132.4]) were found to be associated with prolonged surgical time. CD due to malpresentation (RR, 0.57 [95% CI, 0.46\u20130.7]), multiple gestations (RR, 0.72 [95% CI, 0.6\u20130.9]), and patient request (RR, 0.56 [95% CI, 0.38\u20130.84]) were found to be protective factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The main risk factors associated with additional surgery time in CD are general anesthesia, abnormal placentation, previous uterine scar, and preterm delivery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.15026","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T06:54:45Z","timestamp":1691391285000},"page":"693-698","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The association between indications for cesarean delivery and surgery time"],"prefix":"10.1002","volume":"164","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7290-3477","authenticated-orcid":false,"given":"Daniel","family":"Gabbai","sequence":"first","affiliation":[{"name":"Lis Hospital for Women Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Affiliated to Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anat","family":"Lavie","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Affiliated to Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yariv","family":"Yogev","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Affiliated to Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Attali","sequence":"additional","affiliation":[{"name":"Lis Hospital for Women Tel Aviv Sourasky Medical Center  Tel Aviv Israel"},{"name":"Affiliated to Sackler Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-017-4445-2"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182952242"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2015.07.006"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-019-0895-3"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10729-018-9457-3"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000132"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2012.11.008"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.1999.780709.x"},{"key":"e_1_2_9_10_1","first-page":"4","article-title":"Prolonged operative time of cesarean is a risk marker for subsequent cesarean maternal complications","volume":"8","author":"Lang Ben Nun E","year":"2022","journal-title":"Arch Gynecol Obstet"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.05.054"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.11.047"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2022.04.026"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.06.055"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2017.1421930"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2012.733745"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.12.017"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2018.1439010"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.11.1006"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2021.100360"},{"issue":"6","key":"e_1_2_9_21_1","first-page":"1319","article-title":"Spinal versus epidural anesthesia for Cesarean section","volume":"81","author":"Riley ET","year":"1995","journal-title":"Anesth Analg"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2009.02.013"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000185"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2022.04.007"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000291562.48203.fc"},{"issue":"2","key":"e_1_2_9_26_1","first-page":"20","article-title":"Safe prevention of the primary cesarean delivery","volume":"26","author":"Edwards N","year":"2014","journal-title":"AIMS J"}],"container-title":["International Journal of Gynecology &amp; 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