Repeat Cesarean Sections: Maternal and Neonatal Outcomes and Complications

Yaghmaei, Minoo; Ajori, Ladan; Mokhtari, Mojgan

doi:10.30699/jogcr.9.1.95

Document Type : Original Research Article

Authors

¹ Department of Obstetrics and Gynecology, Taleghani Hospital Research Development Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

² Department of Obstetrics and Gynecology, Preventative Gynecology Research Center (PGRC), School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

³ Department of Obstetrics and Gynecology, Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences, Tehran, Iran

https://doi.org/10.30699/jogcr.9.1.95

Abstract

Background & Objective: Although the safety of cesarean sections has increased, there are still considerations, especially for women with a history of repeated cesarean sections. This study was conducted with the aim of investigating maternal and neonatal outcomes in candidates for cesarean sections due to repeat cesarean sections according to the number of previous cesarean sections.
Materials & Methods: This prospective descriptive study was conducted from April 2020 to June 2022 at Taleghani Hospital. All candidates for cesarean sections due to repeated cesarean sections were included in the study. According to the number of previous cesarean sections, they were divided into three groups. Statistical analysis was performed with Kruskal-Wallis, Chi-squared and Fisher’s exact tests. A P value < 0.05 indicated statistical significance.
Results: A total of 345 women were included in the study. The results of this study showed that these three groups were significantly different in terms of duration of surgery (P<0.001), abnormal placental adhesion (0.012), and the presence of intraperitoneal adhesions (P<0.001), but there was not a significant difference in terms of other maternal and neonatal outcomes (P<0.05).
Conclusion: The results of this study showed that an increase in the number of previous cesarean sections does not increase most maternal and neonatal complications during a current cesarean section. Of course, it should be noted that the number of women with a history of three or more previous cesarean sections was small in this study, and for this reason, more studies are needed.

Highlights

✅ The results of this study showed that an increase in the number of previous cesarean sections does not increase most maternal and neonatal complications during a current cesarean section. Of course, it should be noted that the number of women with a history of three or more previous cesarean sections was small in this study, and for this reason, more studies are needed.

Keywords

Main Subjects

Obstetrics and Gynecology

References

1. Yassaee F, Habibi S, Shekarriz Foumani R, Motiei Langroudi SM, Ghotbi E. Factors Affecting Post-Cesarean Pain Intensity in Patients at Taleghani Hospital in 2021. J Obstet Gynecol Cancer Res. 2023;8(5):457-63. [DOI:10.30699/jogcr.8.5.457]

2. Martin JAMPH, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births: final data for 2016. Natl Vital Stat Rep. 2018;67(1):1-55.

3. Ana Pilar B, Jiangfeng Y, Ann-Beth M, João Paulo S, Jun Z. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health. 2021;6(6):e005671. [DOI:10.1136/bmjgh-2021-005671] [PMID] [PMCID]

4. Rafiei M, Saei Ghare M, Akbari M, Kiani F, Sayehmiri F, Sayehmiri K, et al. Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis. Int J Reprod Biomed. 2018;16(4):221-34. [DOI:10.29252/ijrm.16.4.221] [PMID] [PMCID]

5. AlSheeha MA. Epidemiology of Cesarean Delivery in Qassim, Saudi Arabia. Open Access Maced J Med Sci. 2018;6(5):891-5. [DOI:10.3889/oamjms.2018.213] [PMID] [PMCID]

6. Cunningham F, Leveno K, Dashe J, Hoffman B, Spong C, Casey B. Williams Obstetrics. New York: Mc Graw Hill2022.

7. Clark SL, Belfort MA, Dildy GA, Herbst MA, Meyers JA, Hankins GD. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol. 2008;199(1):36.e1-.e5. [DOI:10.1016/j.ajog.2008.03.007] [PMID]

8. Blankenship SA, Raghuraman N, Delhi A, Woolfolk CL, Wang Y, Macones GA, et al. Association of abnormal first stage of labor duration and maternal and neonatal morbidity. Am J Obstet Gynecol. 2020;223(3):445.e1-.e15. [DOI:10.1016/j.ajog.2020.06.053] [PMID]

9. Kaplanoglu M, Bulbul M, Kaplanoglu D, Bakacak SM. Effect of multiple repeat cesarean sections on maternal morbidity: data from southeast Turkey. Med Sci Monit. 2015;21:1447-53. [DOI:10.12659/MSM.893333] [PMID] [PMCID]

10. Sinha P, Gupta U, Singh J, Srivastava A, Chauhan S. Per operative findings in repeat cesarean section. Int J Reprod Contracept Obstet Gynecol. 2016;5(4):1094. . [DOI:10.18203/2320-1770.ijrcog20160864]

11. Kaplanoglu M, Karateke A, Un B, Akgor U, Baloğlu A. Complications and outcomes of repeat cesarean section in adolescent women. Int J Clin Exp Med. 2014;7(12):5621-8.

12. Hou L, Hellerstein S, Vitonis A, Zou L, Ruan Y, Wang X, et al. Cross sectional study of mode of delivery and maternal and perinatal outcomes in mainland China. PLoS One. 2017;12(2):e0171779. [DOI:10.1371/journal.pone.0171779] [PMID] [PMCID]

13. Alshehri KA, Ammar AA, Aldhubabian MA, Al-Zanbaqi MS, Felimban AA, Alshuaibi MK, et al. Outcomes and Complications After Repeat Cesarean Sections Among King Abdulaziz University Hospital Patients. Mater Socio. 2019;31(2):119-24. [DOI:10.5455/msm.2019.31.119-124] [PMID] [PMCID]

14. Marshall NE, Fu R, Guise J-M. Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Am J Obstet Gynecol. 2011;205(3):262.e1-.e8. [DOI:10.1016/j.ajog.2011.06.035] [PMID]

15. Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006;107(6):1226-32. [DOI:10.1097/01.AOG.0000219750.79480.84] [PMID]

16. Yaman Tunc S, Agacayak E, Sak S, Basaranoglu S, Goruk NY, Turgut A, et al. Multiple repeat caesarean deliveries: do they increase maternal and neonatal morbidity? J Matern Fetal Neonatal Med. 2017;30(6):739-44. [DOI:10.1080/14767058.2016.1183638] [PMID]

17. Hancerliogullari N, Yaman S, Aksoy RT, Tokmak A. Does an increased number of cesarean sections result in greater risk for mother and baby in low-risk, late preterm and term deliveries? Pak J Med Sci. 2019;35(1):10-6. [DOI:10.12669/pjms.35.1.364] [PMID] [PMCID]

18. Biler A, Ekin A, Ozcan A, Inan AH, Vural T, Toz E. Is it safe to have multiple repeat cesarean sections? A high volume tertiary care center experience. Pak J Med Sci. 2017;33(5):1074-9. [DOI:10.12669/pjms.335.12899] [PMID] [PMCID]

19. Uygur D, Gun O, Kelekci S, Ozturk A, Ugur M, Mungan T. Multiple repeat caesarean section: is it safe? Eur J Obstet Gynecol Reprod Biol. 2005;119(2):171-5. [DOI:10.1016/j.ejogrb.2004.07.022] [PMID]

20. Lynch CM, Kearney R, Turner MJ. Maternal morbidity after elective repeat caesarean section after two or more previous procedures. Eur J Obstet Gynecol Reprod Biol. 2003;106(1):10-3. [DOI:10.1016/S0301-2115(02)00196-3] [PMID]

21. Khashoggi Tariq Y. Higher Order Multiple Repeat Cesarean Sections: Maternal and Fetal Outcome. Ann Saudi Med. 2003;23(5):278-82. [DOI:10.5144/0256-4947.2003.278] [PMID]

22. Rashid M, Rashid RS. Higher order repeat caesarean sections: how safe are five or more? BJOG. 2004;111(10):1090-4. [DOI:10.1111/j.1471-0528.2004.00244.x] [PMID]

23. Cook JR, Jarvis S, Knight M, Dhanjal MK. Multiple repeat caesarean section in the UK: incidence and consequences to mother and child. A national, prospective, cohort study. BJOG. 2013;120(1):85-91. [DOI:10.1111/1471-0528.12010] [PMID]

24. Clark SL, Koonings PP, Phelan JP. Placenta previa/accreta and prior cesarean section. Obstet Gynecol. 1985;66(1):89-92.

25. Sobande A, Eskandar M. Multiple Repeat Caesarean Sections: Complications and Outcomes. J Obstet Gynaecol Canada. 2006;28(3):193-7. [DOI:10.1016/S1701-2163(16)32105-3] [PMID]

Journal of Obstetrics, Gynecology and Cancer Research

Repeat Cesarean Sections: Maternal and Neonatal Outcomes and Complications

References

References

Volume 9, Issue 1 - Serial Number 36
January and February 2024
Pages 95-101

Repeat Cesarean Sections: Maternal and Neonatal Outcomes and Complications

References

References

Volume 9, Issue 1 - Serial Number 36January and February 2024Pages 95-101

Volume 9, Issue 1 - Serial Number 36
January and February 2024
Pages 95-101