{
    "abstract": "To compare cesarean complication rates between women with body mass index (BMI) 40-49.9\u2009kg/m(2) and BMI\u2009\u2265\u200950\u2009kg/m(2) and associations with surgical techniques.\nThis retrospective cohort study from 2009 to 2014 included women who underwent cesarean with delivery BMI\u2009\u2265\u200950 and an equal number with BMI 40-49.9. Wound infections and/or separations were compared. We also examined wound complication rates between skin closure techniques and self-retaining retractor use.\nAmong 498 patients (249 with BMI\u2009\u2265\u200950 and 249 with BMI 40-49.9) there were no differences in estimated blood loss >1000\u2009mL, blood transfusion, deep vein thrombosis or endometritis. Among those with outpatient follow-up (144 with BMI\u2009\u2265\u200950 and 162 with BMI 40-49.9), those with BMI\u2009\u2265\u200950 had a significantly higher rate of wound separations (p\u2009=\u20090.01) but not infections. There were no differences in wound complication rates between skin closure techniques or self-retaining retractor use, though the study was not powered for these comparisons.\nWound complications, particularly separations, increase with BMI\u2009\u2265\u200950 compared to a lesser degree of morbid obesity. Skin closure techniques and self-retaining retractor use were not associated with cesarean wound complications in patients with morbid obesity.",
    "authors": [
        {
            "affiliation": "a Department of Obstetrics , Gynecology, and Women's Health, John A Burns School of Medicine, University of Hawaii at Manoa , Honolulu , HI , USA .",
            "firstname": "Kelly",
            "initials": "K",
            "lastname": "Yamasato"
        },
        {
            "affiliation": "a Department of Obstetrics , Gynecology, and Women's Health, John A Burns School of Medicine, University of Hawaii at Manoa , Honolulu , HI , USA .",
            "firstname": "Kurt",
            "initials": "K",
            "lastname": "Yoshino"
        },
        {
            "affiliation": "a Department of Obstetrics , Gynecology, and Women's Health, John A Burns School of Medicine, University of Hawaii at Manoa , Honolulu , HI , USA .",
            "firstname": "Ann L",
            "initials": "AL",
            "lastname": "Chang"
        },
        {
            "affiliation": "b Department of Obstetrics and Gynecology , Oregon Health & Science University , Portland , OR , USA , and.",
            "firstname": "Aaron B",
            "initials": "AB",
            "lastname": "Caughey"
        },
        {
            "affiliation": "c Department of Obstetrics and Gynecology , University of Buffalo , Buffalo , NY , USA.",
            "firstname": "Pai-Jong",
            "initials": "PJ",
            "lastname": "Tsai"
        }
    ],
    "conclusions": "Wound complications, particularly separations, increase with BMI\u2009\u2265\u200950 compared to a lesser degree of morbid obesity. Skin closure techniques and self-retaining retractor use were not associated with cesarean wound complications in patients with morbid obesity.",
    "copyrights": null,
    "doi": "10.3109/14767058.2016.1151869",
    "journal": "The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians",
    "keywords": [
        "Body mass index",
        "cesarean section",
        "delivery",
        "morbid",
        "obesity",
        "obstetric",
        "pregnancy",
        "surgical stapling",
        "sutures"
    ],
    "methods": null,
    "publication_date": "2016-05-24",
    "pubmed_id": "27212261",
    "results": "Among 498 patients (249 with BMI\u2009\u2265\u200950 and 249 with BMI 40-49.9) there were no differences in estimated blood loss >1000\u2009mL, blood transfusion, deep vein thrombosis or endometritis. Among those with outpatient follow-up (144 with BMI\u2009\u2265\u200950 and 162 with BMI 40-49.9), those with BMI\u2009\u2265\u200950 had a significantly higher rate of wound separations (p\u2009=\u20090.01) but not infections. There were no differences in wound complication rates between skin closure techniques or self-retaining retractor use, though the study was not powered for these comparisons.",
    "title": "Cesarean delivery complications in women with morbid obesity.",
    "xml": "<Element 'PubmedArticle' at 0x788504c77470>"
}