Maryam Shoaib, Farida Kakar, Samia Saifullah, Sakina Naeem, Rizwana Naz.
More Than Five Caesarean-Sections: Maternal and Perinatal Outcomes and Associated Risk Factors.
Pak J Med Health Sci Jan ;14(2):1579-81.

Aim: To examine the maternal and neonatal outcomes in patients who received more than five cesarean sections and associated risk factors. Study Design: Case control Place and Duration of Study: Gynecology and Obstetrics Department, Sandeman Provincial Hospital Quetta from 1 st January 2019 to 31st December 2019. Materials and Methods: The number of patients was 100 patients with age ranging between 20-50 years and gestation age >32 weeks. Demographic details including patient`s age, residence, education and socioeconomic status were recorded after written consent. The patients were divided into two groups; Group A (n=50) consisted patients who had undergone five or more C-section deliveries. Group B (n=50) consisted of patients who had less than five C-sections. Intra and post-operative complications were recorded. Neonatal outcomes such as admission to NICU, birth weight, Apgar score and mortality data were recorded and results were compared. Results: In Group A, the incidence of extensive adhesion was high 21 (42%) patients as compared to Group B (10%). Bowel injury found in 3 (6%) patients in Group A while no patient in Group B. Placenta previa found in 6 (12%) in Group A and 1 (2%) patients in Group B. Need of blood transfusion rate was high in Group A, 24% as compared to Group B 8%. In Group A 30% neonates required NICU admission. Low birth weight was higher in Group A patients. 2% neonatal death was recorded in Group A while none in Group B. Conclusion: Patients with five or more C-sections had higher risk of maternal and neonatal morbidity. Patients should be aware about the adverse outcomes of repeated C-section deliveries.

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