Fetal laceration injury at caesarean delivery

ABSTRACT

The purpose of this study was to investigate the incidence, type, location, and risk factors of accidental fetal lacerations during caesarean delivery. Total deliveries, caesarean deliveries, and neonatal records for documented accidental fetal lacerations were reviewed retrospectively in four university hospital. The gestational age, the presenting part of the fetus, the type of incision, and maternal age and parity were recorded. Caesarean deliveries were divided into elective and emergency procedures. Fetal lacerations were grouped according to the location and the need for surgical intervention. Of 19217 deliveries, 8840 women were delivered by caesarean birth [46%]. Neonatal records documented 87 accidental fetal lacerations. Of these accidental lacerations, 16 needed surgical repair and 62 recovered by dressing. Head and neck was the most common site of laceration [64.1%]. The overall rate of accidental fetal laceration per caesarean delivery was 0.88%. The rate of emergency caesarean was 45 [56.69%] and for elective procedures was 33 [42.4%]. The risk for fetal accidental laceration was higher in foetuses who underwent emergency caesarean birth [P<0.001]. Fetal accidental laceration may occur during caesarean delivery and its incidence is significantly higher during emergency caesarean delivery. The patient should be counselled about the occurrence of fetal laceration during caesarean delivery to avoid litigation