Maternal morbidity associated with skin incision type at cesarean delivery in obese patients: a systematic review

AIM: To describe the relationship between cesarean skin incision type and postoperative wound complications (WCs) in obese pregnant patients. MATERIALS & METHODS: MEDLINE (PubMed and 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/m(2) undergoing cesarean delivery and assessing the effect of skin incision type on postoperative 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 WC compared with the vertical skin incision. The pooled risk ratio for WCs was 0.47 (95% CI: 0.37–0.58; p < 0.00001). 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 WCs. PROSPERO registration ID: CRD42020151106