Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared outside of the session

CME Credit Offered

Abstract Award

Recording available 2/16-5/2

AIUM Credit

Foundation Awardee

Poster Icons

Abstract Award

Foundation Awardee

Poster Session 1

Category: Labor

Poster Session 1

(119) Risk Factors for Uterine Incision Extension During Emergency Cesarean Deliveries

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Alla Saban, MD, MPH

Soroka Medical Center
beer sheva, HaDarom, Israel

Coauthor(s)

Noa Leybovitz Haleluya, MD (she/her/hers)

OB/Gyn resident
Soroka Medical Center
meitar, HaDarom, Israel
RH

Reli Hershkovitz, MD

Head of department woman A
Soroka Medical Center, Ben Gurion University of the Negev
beer sheba, HaDarom, Israel
AW

Adi Y. Weintraub, MD

Professor of Obstetrics & Gynecology; Urogynecology & Pelvic Floor Medicine Specialist
Soroka University Medical Center, Faculty of Health Sciences, Ben‑Gurion University of the Negev
beer sheba, HaDarom, Israel
Tamar Eshkoli, MD

Senior
Soroka Medical Center, Ben Gurion University of the Negev
beer sheba, HaDarom, Israel

Objective:
Uterine incision extension during cesarean delivery (CD) can increase maternal morbidity and operative time. This study aimed to identify independent maternal, obstetric, and surgical risk factors associated with uterine incision extension in emergency CDs.

Study Design:
We conducted a case-control study of singleton emergency CDs between Feb 2020 and Jan 2022 at a tertiary center. Exclusion criteria included non-transverse uterine incisions, missing surgical reports, uterine rupture or dehiscence, Müllerian anomalies, placenta accreta, or urgent hysterectomy. Cases were defined as CDs with uterine incision extension, and controls as those without. Clinical, obstetric, and intraoperative variables were compared using bivariate analysis followed by multivariable logistic regression to identify independent risk factors.

Results:

Of 2,676 emergency CDs, 270 (10.1%) were complicated by uterine incision extension. On bivariate analysis (Table 1), factors significantly associated with an increased risk of extensions included younger maternal age (p=0.029), lower gravidity and parity (p< 0.001 and p=0.014, respectively), oligohydramnios (p=0.004), higher neonatal birthweight (p< 0.001), regional anesthesia (p=0.016), and bladder flap dissection (p=0.001). factors associated with reduced risk included preterm delivery< 37 weeks (p< 0.001), hypertensive disorders of pregnancy (p=0.014) and polyhydramnios (p=0.019).
In multivariable logistic regression analysis (Table 2), oligohydramnios (adjusted OR 2.20; 95% CI 1.36–3.55, p=0.001) and bladder flap dissection (adjusted OR 1.54; 95% CI 1.15–2.09, p=0.003) were independently associated with increased odds of uterine incision extension. In contrast, preterm delivery was protective (adjusted OR 0.31; 95% CI 0.18–0.56, p< 0.001).

Conclusion:
Uterine incision extension in emergency CDs is independently associated with bladder flap dissection and oligohydramnios, whereas preterm delivery appears to be protective. Preoperative recognition of these risk factors may assist in optimizing surgical planning and minimizing maternal morbidity.