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Maternal complications associated with multiple cesarean deliveries
Victoria Nisenblat1, Shlomi Barak, Ofra Barnett Griness
1Department of Obstetrics and Gynecology, Bnai-Zion Medical Center, Technion-Israel Institute of Technology, Haifa, Israel. vnisenblat@gmail.com
Obstetrics and Gynecology
|July 4, 2006
Summary
Cesarean delivery complications increase with each subsequent surgery. Women planning larger families face higher risks of excessive blood loss and difficult deliveries after multiple cesarean births.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Outcomes
Background:
- The safety of repeat cesarean delivery versus trial of labor is debated, especially for women desiring multiple children.
- Previous studies may not fully capture risks associated with numerous cesarean births.
Purpose of the Study:
- To evaluate maternal complications in women undergoing multiple cesarean deliveries.
- To compare complication rates after a third or subsequent cesarean delivery versus a second cesarean delivery.
Main Methods:
- Retrospective review of women with two or more planned cesarean deliveries (2000-2005).
- Comparison of maternal complications between a group of 277 women (three or more cesareans) and 491 women (second cesarean).
Main Results:
- The multiple-cesarean group showed significantly higher rates of excessive blood loss, difficult neonatal delivery, and dense adhesions.
- While not statistically significant, placenta accreta and hysterectomy were more frequent in the multiple-cesarean group.
- Major complication rates increased with each cesarean delivery: 4.3% (second), 7.5% (third), and 12.5% (fourth or more).
Conclusions:
- Multiple cesarean deliveries are linked to more challenging surgical procedures and greater blood loss compared to a second cesarean.
- The risk of significant maternal complications escalates with an increasing number of cesarean deliveries.
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