Rabia Adnan, Fatima Waheed, Tayyaba Majeed.
Fetomaternal Morbidity Associated with Multiple Repeat Caesarean Deliveries.
Pak J Med Health Sci Jan ;7(1):165-8.

Objective: To determine fetomaternal morbidity associated with multiple repeat caesarean deliveries. Study Design: Observational Place and duration of study: Gynaecology and Obstetrics, Lady Aitchison Hospital, Lahore. The study period extended from June 2012 to December 2012. Methodology: This study included patients who had repeat cesarean deliveries between June 2012 and December 2012. They were divided into three groups. Group I n=292, (G I), included women who had two caesarean births, Group II n=175, (G II), included women who had three caesarean births and Group III n=38, (G III), included women who had four or more caesarean births. Intra operative complications were noted in terms of dense adhesions, scar dehiscence, placenta previa, morbidly adherent placenta, injury to surrounding viscera, anesthesia complications, need for blood transfusion, and fetal outcome . Women with only one previous delivery were excluded. Results: Compared with women with two cesarean deliveries, women who had more than two cesarean deliveries show significant increase in terms of adhesions, placenta praevia, placental adherence, and need for obstetrical hysterectomy. There was also significant difference in the mean gestational age in the three groups. We found no significant increase between 3 groups in terms of operative time, injury to surrounding structures, need for blood transfusion, anesthesia complications. Conclusions: Women with repeat caesarean sections are at risk of developing multiple intra operative complications which may increase the risk of fetomaternal morbidity but their increasing number does not confer any additional risks.

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