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Readmissions After Cesarean Higher Than Vaginal Delivery

Study notes higher-than-expected rates of postpartum cholecystitis, appendicitis, pneumonia

THURSDAY, Jan. 7 (HealthDay News) -- Hospital readmissions for women in the postpartum period are often due to infections, and women have a higher risk of readmission after cesarean than vaginal deliveries, according to research published in the January issue of the American Journal of Obstetrics & Gynecology.

Michael A. Belfort, M.D., of the Hospital Corporation of America (HCA) in Nashville, Tenn., and colleagues analyzed 222,751 deliveries in 2007 in 114 HCA hospitals to evaluate reasons for readmission after delivery.

Of this group, the researchers found that 2,655 women (1.2 percent) were readmitted within six weeks. Readmission was more common after cesarean than vaginal delivery (1.8 versus 0.83 percent). Hypertension and uterine and wound infections were the most common reasons for readmission, though readmissions for cholecystitis, appendicitis, and pneumonia were also notable.

"Our data confirm that, although readmissions in the first six weeks after delivery are uncommon, cesarean delivery carries with it roughly twice the risk for readmission as does vaginal birth," the authors write. "Perhaps of most interest was our observation of a significantly higher rate of hospital readmission for cholecystitis, appendicitis, and pneumonia in the first few postpartum weeks than would be expected by chance. None of these conditions has ever before been linked causally to pregnancy or delivery."

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