Re‐exploration following caesarean birth: a prospective national case–control study using the United Kingdom Obstetric Surveillance System ( UKOSS ) data collection system
Authors' conclusion
Re-exploration following caesarean birth in the UK is uncommon but is associated with significant maternal morbidity and mortality.
Study context
- Population
- Women having caesarean birth in 194 UK consultant-led maternity units, 1 June 2021 to 31 May 2022
- Participants
- 238,423 caesarean births
- Exposure
- Women with re-exploration following caesarean birth vs controls
- Re-explorationn = 187
- Outcome
- National incidence of re-exploration following caesarean birth and associated risk factors
Methodological detailsmulticentre, national surveillance (UKOSS), multivariable multi-level mixed effects logistic regression
- Multicentre
- National surveillance (UKOSS)
- Multivariable multi-level mixed effects logistic regression
Main finding
As reported in the abstract
Incidence of re-exploration
One re-exploration per 1282 caesarean births
1:1282
95% CI 1:1099–1:1471
Observational data: associations, not effects.
Further findings
Independent preceding factors associated with re-exploration (multivariable multi-level mixed effects logistic regression)
| Adjusted OR (95% CI) | ||
|---|---|---|
| Receipt of blood transfusion | 8.25 (2.66–25.61) | |
| Use of a general anaesthetic | 3.33 (1.61–6.88) | |
| Pre-eclampsia | 3.27 (1.55–6.91) | |
| Black ethnicity | 3.14 (1.39–7.11) | |
| Postpartum haemorrhage | 2.82 (1.81–4.37) | |
| Use of anticoagulants or antiplatelet drugs pre-caesarean birth | 2.26 (1.35–3.81) | |
| Emergency caesarean birth | 1.89 (1.01–3.57) | |
| 0.050.21520Adjusted odds ratio (log scale) |
Findings at re-exploration
- Haemorrhage
- 124/187, 66.3%
- Sepsis
- 31/187, 16.6%
Time interval to re-exploration following caesarean birth
- Median (IQR [range]), day
- 1 (0-4 [0-28])
Maternal morbidity and mortality after re-exploration
- Mechanical ventilation required
- 34 (18.6%)
- Cardiac arrest
- 5 (2.7%)
- Died
- 3 (1.6%)
Original publication
Re‐exploration following caesarean birth: a prospective national case–control study using the United Kingdom Obstetric Surveillance System ( UKOSS ) data collection system. Anaesthesia. Published 31 July 2024. doi:10.
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