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Multiple caesarean sections: outcomes and complications.

¹Department of Obstetrics and Gynaecology, University of Oulu, Finland.

British Journal of Obstetrics and Gynaecology

|August 1, 1988

Summary

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Women with multiple caesarean sections face increased risks like uterine scar fenestration and longer operation times. However, elective delivery is often possible, and no absolute limit exists for repeat procedures.

Area of Science:

Obstetrics and Gynecology
Reproductive Medicine

Background:

Caesarean section is a common surgical procedure.
Repeat caesarean sections are increasingly performed.
Understanding risks associated with multiple caesarean sections is crucial for patient care.

Purpose of the Study:

To compare the outcomes and complications of repeat caesarean sections (three or more previous) with first or second caesarean sections.
To identify specific risks associated with multiple caesarean sections.

Main Methods:

Retrospective comparison of two groups of women undergoing caesarean section.
Group 1: 64 women with 3-8 previous caesarean sections (mean 4).
Group 2: 61 women with 1-2 previous caesarean sections.

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Main Results:

Women with multiple caesarean sections had slightly lower gestational age at delivery.
27% of women with multiple sections developed uterine scar fenestration, often asymptomatic.
Increased operative time and 13% required caesarean hysterectomy in the multiple section group.
No significant differences in other operative or postoperative complications were observed.

Conclusions:

Multiple caesarean sections are associated with specific complications like uterine scar fenestration and increased operative time.
Elective delivery is generally feasible until fetal maturity in women with multiple caesarean sections.
No definitive upper limit for the number of repeat caesarean sections can be established.