{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:27:28Z","timestamp":1730870848410,"version":"3.28.0"},"reference-count":5,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to evaluate cesarean rates and risk for obstetric complications among deliveries with a history of prior uterine surgery.<\/jats:p><jats:p>\n            Study Design\u2003This serial cross-sectional study analyzed deliveries with and without prior uterine surgery in the 2016\u20132019 Nationwide Inpatient Sample. Unadjusted and adjusted logistic regression models were performed to assess risk of nontransfusion severe maternal morbidity (SMM) and other obstetric complications based on the presence or absence of prior uterine surgery with unadjusted and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) as measures of association. Adjusted models accounted for demographic, hospital, and delivery factors. Demographics and clinical factors among deliveries with and without a prior history of uterine surgery diagnosis were compared with the chi-square test with p\u2009&lt;\u20090.05 considered statistically significant.<\/jats:p><jats:p>\n            Results\u2003Of 14.7 million delivery hospitalization identified, 6,910 (4.7 per 10,000) had a history of uterine surgery and 111,710 (0.76%) experienced SMM. Women with prior uterine surgery were more likely to be older, to be of unknown race or ethnicity, and to have private insurance (p\u2009&lt;\u20090.01 for all). Eighty-five percent of deliveries with prior uterine surgery were performed by cesarean compared with 32% of deliveries without prior uterine surgery (p\u2009&lt;\u20090.01). In adjusted analysis, compared with patients without prior uterine surgery, patients with prior uterine surgery were not at increased risk for SMM (aOR 1.23, 95% CI 0.73\u20132.07). Evaluating obstetric complications, patients with prior uterine surgery had a decreased risk of postpartum hemorrhage (aOR 0.64, 95% CI 0.43\u20130.96) and an increased risk of peripartum hysterectomy (aOR 4.12, 95% CI 1.75\u20139.67), and no difference in other obstetric complications assessed.<\/jats:p><jats:p>\n            Conclusion\u2003These findings suggest that current clinical practice results in similar delivery risks among patients with compared with without prior uterine surgery.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2211-1928","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T01:20:47Z","timestamp":1700097647000},"page":"e3183-e3186","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Mode of Delivery and Obstetric Complications in the Setting of Prior Uterine Surgery"],"prefix":"10.1055","volume":"41","author":[{"given":"Margaret H.","family":"Bogardus","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander M.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chetna","family":"Arora","sequence":"additional","affiliation":[{"name":"Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary E.","family":"D'Alton","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Wen","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1111\/1471-0528.14640","article-title":"Epidemiology of uterine fibroids: a systematic review","volume":"124","author":"E A Stewart","year":"2017","journal-title":"BJOG"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1016\/j.fertnstert.2017.06.034","article-title":"Removal of myomas in asymptomatic patients to improve fertility and\/or reduce miscarriage rate: a guideline","volume":"108","author":"Practice Committee of the American Society for Reproductive Medicine. Electronic address: ASRM@asrm.org","year":"2017","journal-title":"Fertil Steril"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.rbmo.2014.09.006","article-title":"Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies","volume":"29","author":"C A Venetis","year":"2014","journal-title":"Reprod Biomed Online"},{"issue":"03","key":"ref4","first-page":"225","article-title":"The impact of uterine leiomyomas on reproductive outcomes","volume":"62","author":"H Cook","year":"2010","journal-title":"Minerva Ginecol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/s10397-014-0842-8","article-title":"The risk of uterine rupture after myomectomy: a systematic review of the literature and meta-analysis","volume":"11","author":"J Claeys","year":"2014","journal-title":"Gynecol Surg"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2211-1928.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:51:19Z","timestamp":1730814679000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2211-1928"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,15]]},"references-count":5,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2211-1928","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2023,11,15]]},"published":{"date-parts":[[2023,11,15]]}}}