Abstract
Objective:To compare the obstetric outcomes of cesarean section in women who had a history of four or more previous cesarean sections with those who had a history of two or three previous cesarean sections.Methods:Total 1318 women who underwent repeat cesarean section between January 2013 and January 2016 were retrospectively reviewed. Of these, 244 (18.5%) had previously had four or more cesarean sections (multiple repeat cesarean section group) and 1074 (81.5%) had previously had two or three cesarean sections (control group). Demographic characteristics and obstetric outcomes were compared using the Independent t and chi-square tests.Results:The adhesion rate (p < 0.001), number of blood transfusion (p = 0.044), operation time (p = 0.012), length of hospital stay (p < 0.001) and tubal ligation surgery (p < 0.001) were significantly higher in multiple repeat cesarean section group compared to control group.Conclusion:Although multiple repeat cesarean section are asscociated with adhesion occurrence, higher number of blood transfusion, increased operation time and length of hospital stay, there is no remarkable difference in serious morbidity associated with multiple repeat cesarean section.
Highlights
Cesarean deliveries have risen significantly over the past decades due to advanced maternal age, defensive obstetric practice, medicolegal concerns and maternal request
In Turkey, the cesarean section (CS) rate increased from 8% to 37% between 1993 and 2008.1 CS is a surgical procedure including some risks such as uterine rupture, infection, hemorrhage, thrombosis and damage to the bladder, ureters or bowel.[2]
Maternal outcomes according to groups were shown in Table-II
Summary
Cesarean deliveries have risen significantly over the past decades due to advanced maternal age, defensive obstetric practice, medicolegal concerns and maternal request. In Turkey, the cesarean section (CS) rate increased from 8% to 37% between 1993 and 2008.1 CS is a surgical procedure including some risks such as uterine rupture, infection, hemorrhage, thrombosis and damage to the bladder, ureters or bowel.[2] CS is safe along with devolopments in anesthesia and surgery, these complications of CS can be life-threatening for both mother and baby.[3] Compared with primary CS, multiple repeat caesarean sections (MRCS) are associated with additional risks including placenta previa, abnormal placental invasion and difficulties in surgical dissection. Due to the overall rise in cesarean frequency in developing countries, an increasing number of. Many clinicians suggest sterilization to women following two or three CSs due to risk of uterine rupture and several complications. There has been an ongoing debate about the recommended maximum number of CSs that a woman may safely have
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