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Am J Perinatol 2017; 34(03): 289-294
DOI: 10.1055/s-0036-1586750
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Class III Obese Women's Preferences and Concerns for Cesarean Skin Incision: A Multicenter Survey

Marcela C. Smid
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Rodney K. Edwards
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Joseph R. Biggio
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Karen Dorman
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Rachel C. Leduke
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Laurie L. Lesher
3   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
,
Tracy A. Manuck
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
3   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
,
George R. Saade
4   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
Ashley E. Salazar
4   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas
,
David M. Stamilio
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Alison M. Stuebe
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina
,
Alan T.N. Tita
2   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
,
Caroline M. Torres
5   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University, New York, New York
,
Michael W. Varner
3   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah
,
Ronald J. Wapner
5   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University, New York, New York
› Author Affiliations
Further Information

Publication History

14 March 2016

07 July 2016

Publication Date:
17 August 2016 (online)

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Abstract

Objective This study aims to assess class III obese women's preferences and concerns regarding cesarean delivery (CD) skin incisions.

Study Design Through the National Perinatal Research Consortium (NPRC), women with body mass index ≥ 40 kg/m2 at the time of enrollment completed an anonymous survey in English or Spanish. We evaluated seven domains of preferences and concerns about the cesarean skin incision.

Results We surveyed 546 women at five NPRC sites. Median age (interquartile range) was 29 (25, 35) years; 364 (66%) were parous and 161 (30%) had a prior CD. Women self-identified race/ethnicity as White (31%), non-Hispanic Black (31%), Hispanic (31%), other (6%), and not reported (1%). A total of 542 women (99%) rated both delivering the baby in the best possible condition and decreasing incision opening/infection risk as important. Women were less likely to rate other domains as important (all p < 0.001), including: having least pain possible, n = 521 (95%); decreasing the risk of complications in the next pregnancy, n = 490 (90%); decreasing interference with breastfeeding, n = 474 (87%); decreasing operative time, n = 388 (71%); and having the least visible incision, n = 369 (68%).

Conclusion Women with class III obesity prioritize immediate maternal and fetal safety regarding CD skin incision over other concerns including cosmetic outcome.

Keywords

obesity - cesarean delivery - patient preference - survey

Supplementary Material

 

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