Abstract
Objective: To observe the effects of repeat cesarean
sections on mother and fetal outcomes.
Methodology: This observational study was
conducted in the Obstetrics and Gynecology
Department, District Headquarter Hospital,
Rawalpindi, Pakistan from Feb 2019 to Jan 2020. The
study included recurrent cesarean patients, divided into
three groups; Group I women (n = 300) who had 2
births by C-section, Group II (n = 185) included
women who had 3 births by C-section, and Group III
(n = 45) included women who had four or more Csection. Case records were analyzed for demographic
and clinical features such as age, duration of surgery,
parity, and hospitalstay prenatal complications and
estimated blood loss (EBL) during surgery.
Intraoperative complications were observed in terms of
severe adhesions, scar separation, placenta praevia,
morbid adherent placenta, surrounding intestinal
damage, anesthetic complications, the need for blood
transfusions and fetal outcomes.
Results: A significant increase was observed in
women with more than two cesarean births in
adhesions, placenta adhesion, placenta praevia and
obstetric hysterectomy requirements. We could not
find a significant increase in surgery time, injuries to
surrounding structures, need for blood transfusions,
and anesthesia complications between the three
groups.
Conclusion: Women with recurrent cesarean sections
are at risk of developing intraoperative complications
that may increase the risk of fetal and maternal
morbidity, but their greater number does not constitute
an additional risk.
Keywords: Cesarean section, morbidity,
fetomaternal, adhesions.
