Multiple repeat cesarean sections

Abstract

A review of 282 patients with four or more cesarean sections over a period of 7 years (1956 through 1962) at an exclusively maternity hospital is presented.The statistical data indicate that waiting until the thirty-eighth week of gestation does not increase the danger of weakness of the previous scar and assures a mature baby.The incidence of placenta previa is more than ten times that of all deliveries.Placenta accreta seems to occur sufficiently often in cases in which the placenta overlies the previous scar to warrant serious consideration.The possibility of hysterectomy for placenta accreta or a weakened scar must be anticipated.The over-all incidence of postoperative morbidity and complications are no higher than for primary cesarean sections or any other major abdominal procedures.Repeat cesarean sections, regardless of number, can be performed without the addition of significant risk to the mother or the fetus, provided they are done by qualified physicians and with adequate hospital facilities.