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Multiple repeat caesarean deliveries: do they increase maternal and neonatal morbidity?
Senem Yaman Tunc1, Elif Agacayak1, Sibel Sak2
1a Department of Obstetrics and Gynecology , School of Medicine, Dicle University , Diyarbakir , Turkey.
Summary
Multiple repeat caesarean deliveries (MRCDs) are associated with increased maternal and neonatal morbidity. While not life-threatening, these risks highlight the importance of careful consideration in obstetric planning for women undergoing repeated C-sections.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Outcomes Research
Background:
- The increasing trend of caesarean deliveries (CDs) necessitates understanding the associated risks, particularly in cases of multiple repeat caesarean deliveries (MRCDs).
- Previous research has explored risks associated with repeat C-sections, but a detailed analysis of morbidity across increasing numbers of MRCDs is crucial.
Purpose of the Study:
- To evaluate the impact of an increasing number of caesarean deliveries (CDs) in multiple repeat caesarean deliveries (MRCDs) on maternal and neonatal morbidity.
- To identify specific complications associated with higher-order MRCDs.
Main Methods:
- A retrospective analysis of 1133 women undergoing MRCDs between January 2013 and September 2014.
- Patients were categorized into four groups based on the number of previous CDs: second (n=329), third (n=225), fourth (n=447), and fifth (n=132).
- Clinical, demographic, intraoperative, and postoperative data were collected and analyzed.
Main Results:
- Statistically significant differences were observed in mean maternal age, gravida, APGAR scores, hospital stay, and operation time across the groups.
- Severe adhesion and bladder injury showed a statistically significant increase with a higher number of MRCDs.
- Premature birth rates were also significantly affected by the number of repeat C-sections.
- No significant differences were found for placenta previa, placenta accreta, caesarean hysterectomy, or uterine scar rupture.
Conclusions:
- Multiple repeat caesarean deliveries (MRCDs) are associated with increased maternal and neonatal morbidity.
- While the observed morbidities are generally not life-threatening, they indicate a rising risk profile with each successive repeat C-section.
- These findings underscore the need for careful management and counseling for women undergoing multiple repeat caesarean deliveries.
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