[Post-operative complications following elective and emergency caesarean delivery]

1) To analyze the frequency of complications after elective/planned [PCS] and emergency Cesarean section [ECS]; 2) To compare the types of complications in the two evaluated groups; 3) To analyze the possible risk factors for complications after elective and emergency procedures.

The study was retrospective, hospital-based one. Data regarding complications following Cesarean section [CS] that demanded transfer of the patients to The Clinic of High Infectious Risk, State University Hospital "Maichin Dom", Sofia and prolonged hospital stay (more than 7 days after the operation) were analyzed. The incidence of complications in 574 consecutive PCS and in 292 ECS was calculated. The type of the following complications was compared in the two groups: uterine infections (endo/mio/ metrophlebitis), wound infection, subfascial hematoma, residua, sepsis, pelvic thrombophlebitis. Statistical evaluation of the results was performed by Student's t-test with p<0.05 considered statistically significant.

In 574 PCS the frequency of postoperative complications was 1,4% while in 292 ECS it was 2,05% (p>0.05). There was not significant difference in the distribution of the different types of postoperative complications in 34 cases with PCS and 33 cases with ECS. The percentage of patients with previous CS was significantly higher in the complicated cases with PCS compared to that with ECS. The two studied groups do not differ significantly regarding the type of skin incision, operator's qualification, blood loss, drainage of the subfascial space, accompanying diseases.

Cesarean section constitutes a major surgical procedure characterised with morbidity even if performed as a planned procedure. The risk of complications seems to be higher in cases of repeated CS. Patients that demand CS without medical indications have to be informed and be aware of these facts.