Maternal Morbidity associated with Skin Incision Type at Cesarean Delivery in Obese Patients: A Systematic Review

OBJECTIVE: To describe the relationship between cesarean skin incision type and postoperative wound complications in obese pregnant patients. MATERIALS AND METHODS: MEDLINE (PubMed, OVID), Embase, Scopus, Web of Science Core Collection, Cochrane Library, and ClinicalTrials.gov databases were used for publication search. Selection criteria consisted of articles studying pregnant patients with BMI ≥30 kg/m2 undergoing cesarean delivery and assessing the effect of skin incision type on post-operative maternal outcomes. RESULTS: Ten publications met criteria for a systematic review of a total of 2946 patients. The transverse skin incision was associated with a lower rate of wound complication compared with the vertical skin incision. The pooled risk-ratio for wound complications was 0.47 (95% CI 0.37-0.58, p CONCLUSION: Transverse skin incision may be preferable to vertical skin incision at cesarean delivery in pregnant patients with obesity as it may be associated with a lower rate of wound complications.