One in 60 Women Undergoing C-Section Experience Severe Perioperative Morbidity
TUESDAY, Sept. 2, 2025 -- Nearly one in 60 patients undergoing cesarean delivery experiences severe perioperative surgical morbidity, according to a study published online Aug. 21 in Obstetrics & Gynecology.
Alexander Butwick, from University of California, San Francisco, and colleagues evaluated the prevalence and risk factors for severe perioperative surgical morbidity among patients undergoing cesarean delivery. The analysis included 594,655 cesarean deliveries in any California hospital between 2016 and 2021.
The researchers identified 10,182 individuals with severe perioperative surgical morbidity, including most commonly wound complications (59 per 10,000); bladder, genitourinary, or pelvic injury (45 per 10,000); ileus or bowel obstruction (33 per 10,000); shock (15 per 10,000); and intraoperative bowel injury (14 per 10,000). Among patients undergoing intrapartum cesarean delivery, severe perioperative surgical morbidity prevalence was higher than for prelabor cesarean delivery (203 versus 146 per 10,000). The highest severe perioperative surgical morbidity risk was seen among patients with placenta accreta spectrum disorder (adjusted risk ratio, 15.3).
"The new measure relies on routinely collected hospital claims data and could serve as a foundation for monitoring surgical quality and guiding improvement efforts across hospitals," Butwick said in a statement. "This work marks a major step toward better defining and addressing surgical risk in obstetric care."
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