The Prevalence of Maternal and Newborn Morbidity Following a Repeat Cesarean Section: Data From Zagazig University Hospital

Abstract

Background and Objective: Cesarean section (CS) is one of the most common obstetric procedures performed worldwide, and new research indicates that the frequency of CS is increasing. Maternal-fetal morbidity and death due to CS is a serious public health problem worldwide. Our study aimed to assess the impact of multiple cesarean sections (CSs) on mother-fetal morbidity. Methods: This cross-sectional study was performed on 165 women who underwent multiple repeated CSs in our clinic and met the criteria of inclusion by evaluating their records. All women were divided into 3 groups according to the number of CSs: 2nd (n = 111), 3rd (n = 44), and 4th/5th (n = 10). Maternal-neonatal outcomes; blood transfusion needs, adhesions, APGAR scores, and respiratory difficulties were investigated retrospectively. Results: Our results revealed that adhesion (60.6 %) was the most frequent maternal complication. The prevalence of thick adhesions decreased with the number of cesarean sections performed (70, 25, and 5 cases for the previous 2nd, 3rd, and 4 or more CS, respectively). There was no statistically significant difference between the groups in terms of adhesions, uterine rupture, bladder injury, endometritis, and wound infection. NICU admission (14.5 %), Low birth weight (3.6 %), and IUGR (3.03 %) were among the unfavorable fetal outcomes. There was a significant difference among the three studied groups regarding APGAR score, maternal age, and hospital stay, while a non-significance was found in birth weight and maternal adhesion. Conclusion: Our findings support our hypothesis that the likelihood of maternal complications rises as the number of CSs rises. The manner and time of delivery have a greater impact on infant outcome than the number of CSs. There is no clear absolute barrier for the number of CSs, however, 4 or more cesarean births were recognized as the essential level for the majority of outcomes. The number of CSs must be decreased to reduce the associated issues.