Higher order multiple repeat cesarean sections: maternal and fetal outcome

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Surgical Outcomes

Background:

• Multiple repeat cesarean deliveries are prevalent in Saudi Arabia.
• Assessing complications and neonatal outcomes of multiple repeat cesarean sections is crucial.

Purpose of the Study:

• To compare major and minor complications and neonatal outcomes between high-order (4-8) and lower-order (2-3) repeat cesarean sections.
• To evaluate the safety profile of multiple repeat cesarean deliveries.

Main Methods:

• Retrospective analysis of 150 patients undergoing 4-8 cesarean sections versus 140 patients undergoing 2-3 cesarean sections.
• Data collected from 1996-2000 at Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia.

Main Results:

• Lower mean gestational age (36 vs 37 weeks) and birth weight (2.9 vs 3.1 kg) in the higher-order group.
• Increased operative time (63 vs 45 minutes) and severe adhesions (80 vs 40 cases) in the higher-order group.
• No significant differences in Apgar scores, neonatal admission rates, or specific surgical complications (hysterectomy, scar dehiscence, placenta accreta, bladder injury).

Conclusions:

• Higher-order repeat cesarean sections (4-8) do not present additional risks beyond those typically seen in lower-order procedures (2-3).
• The safety profile for multiple repeat cesarean sections is comparable to lower-order repeat procedures.