Effects of repeated caesarean section on maternal and neonatal outcomes

Abstract

Objective To investigate the effects of repeated caesarean section (RCS) on maternal and neonatal outcomes. Methods From January 1998 to December 2007, 412 cases underwent RCS at Peking Union Medical College Hospital were reviewed and divided into two groups based on the number of CSs: RCS group (n= 394) and multiple caesarean section (CS) group (MCS group, n= 18). General conditions, maternal complications and neonatal outcomes were compared among RCS group, MCS group and first CS groups (FCS group) which consisted of 480 women underwent the first CS during the same period. Results The incidence of RCS was 4. 0% with an increasing trend during the past ten years. (1) The mean age of RCS and MCS group were (33.7± 4. 3) yrs and (34. 5±5.1)yrs respectively, higher than FCS group (P<0. 05). The average gravidity in RCS and MCS group were (3.5±1.4), (4. 7±1.5) respectively, higher than FCS group (2.1± 1.2, P<0. 05). (2) The rate of severe pelvic adhesion and uterus rupture were significantly higher in RCS group than in FCS group (13.5% vs 0. 4%, 1% vs 0%, P<0. 05). (3) The mean gestations of RCS group and MCS group were (38.1±1.8)weeks and (37.3±2.5)weeks respectively, while it was (38. 9±2. 1) weeks in the FCS group (P<0. 05). Conclusions RCS rate is growing. Although RCS would increase the incidence of dense adhesion and uterine rupture, it is a relatively safe procedure without increasing the neonatal morbidity. Key words: Cesarean section, repeat;  Pregnancy outcome;  Adhesions;  Uterine rupture