Complications associated with higher order compared to lower order cesarean sections

Area of Science:

• Obstetrics and Gynecology
• Surgical Complications
• Maternal Health

Background:

• Rising rates of multiple cesarean sections contribute to maternal morbidity and mortality.
• Cultural factors and family size preferences influence the increasing incidence of repeat cesarean deliveries.
• Understanding complications associated with higher-order cesarean sections is crucial for patient safety.

Purpose of the Study:

• To compare complications between higher-order (≥3) and lower-order (1) cesarean sections.
• To identify specific intraoperative and postoperative risks associated with repeat cesarean deliveries.
• To evaluate the association between the number of prior cesarean sections and adverse outcomes.

Main Methods:

• Retrospective review of hospital records for 450 women undergoing repeat cesarean sections over two years.
• Group 1: Women with ≥3 previous cesarean sections; Group 2: Women with one previous cesarean section.
• Data analysis included antenatal, intraoperative, and postoperative outcomes using SPSS, with statistical significance assessed by p-values and confidence intervals.

Main Results:

• Women with ≥3 cesarean sections (Group 1) had a significantly higher risk of dense omental adhesions (4.14%) and bladder injuries (1.38%) compared to women with one cesarean section (Group 2).
• Emergency cesarean sections and unbooked admissions were more frequent in Group 2.
• Logistic regression indicated a 5-fold increased odds of bladder injury and 4.7-fold increased odds of blood transfusion in women with >3 cesarean sections, though these were not statistically significant.

Conclusions:

• Higher-order cesarean sections (≥3) are associated with a significantly increased risk of dense omental adhesions and bladder injuries.
• While logistic regression suggested higher odds for bladder injury and blood transfusion in women with >3 repeat cesarean sections, these findings require further investigation due to lack of statistical significance.
• The study highlights the importance of careful surgical planning and risk assessment in women undergoing multiple repeat cesarean sections.