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Related Experiment Videos

Are multiple cesarean sections safe?

D S Seidman1, I Paz, A Nadu

  • 1Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|October 1, 1994
PubMed
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High-order cesarean sections (4th or more) show minimal maternal risk but increase neonatal risks, primarily due to preterm, non-elective deliveries. This impacts Apgar scores and intensive care needs.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Surgical Outcomes Research

Background:

  • High-order cesarean sections (CS) are increasing globally.
  • Understanding associated maternal and neonatal risks is crucial for clinical practice.

Purpose of the Study:

  • To evaluate maternal and neonatal complications in women undergoing their fourth or higher CS.
  • To compare outcomes with women undergoing second/third CS and those with spontaneous vaginal birth.

Main Methods:

  • A case-control study involving 154 women with CS ≥4, 148 with CS 2-3, and 132 after spontaneous birth.
  • Assessed maternal operative/postoperative morbidity and neonatal outcomes (prematurity, Apgar scores, intensive care).

Main Results:

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  • Women with CS ≥4 had significantly more intra-abdominal adhesions (P < 0.0001).
  • Postoperative maternal course was not adversely affected.
  • Increased neonatal intensive care (P < 0.05) and lower Apgar scores (P < 0.01) were linked to CS ≥4, mainly due to prematurity from non-elective preterm births.

Conclusions:

  • Multiple cesarean sections (≥4) pose minimal maternal risk.
  • Neonatal risks, including lower Apgar scores and increased intensive care, are associated with high-order CS, primarily due to preterm non-elective deliveries.