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Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Research Article

The Prevalence of Maternal and Newborn Morbidity Following a Repeat Cesarean Section: Data From Zagazig University Hospital

Author(s): Ali El-Shabrawy Ali, Amira I. Badr*, Manal Mohamed El-Behairy and Wael Sabry Noseir

Volume 19, Issue 3, 2023

Published on: 17 August, 2022

Article ID: e180522204999 Pages: 7

DOI: 10.2174/1573404818666220518162059

Price: $65

Abstract

Background and Objective: Cesarean section (CS) is one of the most common obstetric procedures performed worldwide, and new research indicates that the frequency of CS is increasing.

Maternal-fetal morbidity and death due to CS is a serious public health problems worldwide. Our study aimed to assess the impact of multiple cesarean sections (CSs) on mother-fetal morbidity.

Methods: This cross-sectional study was performed on 165 women who underwent multiple repeated CSs in our clinic and met the criteria of inclusion by evaluating their records. All women were divided into 3 groups according to the number of CSs: 2nd (n = 111), 3rd (n = 44), and 4th/5th (n = 10). Maternal-neonatal outcomes; blood transfusion needs, adhesions, APGAR scores, and respiratory difficulties were investigated retrospectively.

Results: Our results revealed that adhesion (60.6 %) was the most frequent maternal complication. The prevalence of thick adhesions decreased with the number of cesarean sections performed (70, 25, and 5 cases for the previous 2nd, 3rd, and 4 or more CS, respectively). There was no statistically significant difference between the groups in terms of adhesions, uterine rupture, bladder injury, endometritis, and wound infection. NICU admission (14.5 %), Low birth weight (3.6 %), and IUGR (3.03 %) were among the unfavorable fetal outcomes. There was a significant difference among the three studied groups regarding APGAR score, maternal age, and hospital stay, while a nonsignificance was found in birth weight and maternal adhesion.

Conclusion: Our findings support our hypothesis that the likelihood of maternal complications rises as the number of CSs rises. The manner and time of delivery have a greater impact on infant outcome than the number of CSs. There is no clear absolute barrier for the number of CSs. However, 4 or more cesarean births were recognized as the essential level for the majority of outcomes. The number of CSs must be decreased to reduce the associated issues.

Keywords: Caesarean section, multiple deliveries, maternal outcomes, fetal outcomes, adhesion, NICU admission.

[1]
MacDorman MF, Menacker F, Declercq E. Cesarean birth in the United States: Epidemiology, trends, and outcomes. Clin Perinatol 2008; 35(2): 293-307.
[http://dx.doi.org/10.1016/j.clp.2008.03.007] [PMID: 18456070]
[2]
Alshehri KA, Ammar AA, Aldhubabian MA, et al. Outcomes and complications after repeat cesarean sections among King Abdulaziz University Hospital Patients. Mater Sociomed 2019; 31(2): 119-24.
[http://dx.doi.org/10.5455/msm.2019.31.119-124] [PMID: 31452637]
[3]
McCall SJ, Semaan A, Altijani N, Opondo C, Abdel-Fattah M, Kabakian-Khasholian T. Trends, wealth inequalities and the role of the private sector in caesarean section in the Middle East and North Africa: A repeat cross-sectional analysis of population-based surveys. PLoS One 2021; 16(11): e0259791.
[http://dx.doi.org/10.1371/journal.pone.0259791] [PMID: 34784384]
[4]
Barbosa VS, Francescantônio PL, Silva NA. Leptin and adiponectin in patients with systemic lupus erythematosus: Clinical and laboratory correlations. Rev Bras Reumatol 2015; 55(2): 140-5.
[http://dx.doi.org/10.1016/j.rbr.2014.08.014] [PMID: 25440710]
[5]
Adnan R, Waheed F, Majeed T. Fetomaternal morbidity associated with multiple repeat caesarean deliveries. Pak J Med Health Sci 2013; 7: 165-8.
[6]
Mengesha MB, Adhanu HH, Weldegeorges DA, et al. Maternal and fetal outcomes of cesarean delivery and factors associated with its unfavorable management outcomes; in Ayder Specialized Comprehensive Hospital, Mekelle, Tigray, Ethiopia, 2017. BMC Res Notes 2019; 12(1): 650.
[http://dx.doi.org/10.1186/s13104-019-4690-5] [PMID: 31590693]
[7]
Sobhy S, Arroyo-Manzano D, Murugesu N, et al. Maternal and perinatal mortality and complications associated with caesarean section in low-income and middle-income countries: A systematic review and meta-analysis. Obstet Anesthes Dig 2020; 40(1): 16-8.
[http://dx.doi.org/10.1097/01.aoa.0000652820.07964.a2]
[8]
Kaplanoglu M, Karateke A, Un B, Akgor U. Baloğlu A. Complications and outcomes of repeat cesarean section in adolescent women. Int J Clin Exp Med 2014; 7(12): 5621-8.
[PMID: 25664081]
[9]
Shearer EL. Cesarean section: Medical benefits and costs. Soc Sci Med 1993; 37(10): 1223-31.
[http://dx.doi.org/10.1016/0277-9536(93)90334-Z] [PMID: 8272901]
[10]
Notzon FC, Placek PJ, Taffel SM. Comparisons of national cesarean-section rates. N Engl J Med 1987; 316(7): 386-9.
[http://dx.doi.org/10.1056/NEJM198702123160706] [PMID: 3807975]
[11]
Biler A, Ekin A, Ozcan A. İnan AH, Vural T, Toz E Is it safe to have multiple repeat cesarean sections? A high volume tertiary care center experience Pak J Med Sci 2017; 33(5): 1074-9.
[http://dx.doi.org/10.12669/pjms.335.12899] [PMID: 29142541]
[12]
Choudhary G, Patell M, Sulieman H. The effects of repeated caesarean sections on maternal and fetal outcomes. Saudi J Med Med Sci 2015; 3(1): 44.
[http://dx.doi.org/10.4103/1658-631X.149676]
[13]
Kornacka MK, Kufel K. Neonatal outcome after cesarean section. Ginekol Pol 2011; 82(8): 612-7.
[PMID: 21957607]
[14]
Molina G, Weiser T, Lipsitz S, et al. Relationship between cesarean delivery rate and maternal and neonatal mortality. Obstet Anesthes Dig 2016; 36(4): 171-2.
[http://dx.doi.org/10.1097/01.aoa.0000504695.85376.b3]
[15]
Kaplanoglu M, Bulbul M, Kaplanoglu D, Bakacak SM. Effect of multiple repeat cesarean sections on maternal morbidity: Data from southeast Turkey. Med Sci Monit 2015; 21: 1447-53.
[http://dx.doi.org/10.12659/MSM.893333] [PMID: 25989945]
[16]
Moges A, Ademe B, Akessa G. Prevalence and outcome of caesarean section in Attat Hospital, Gurage Zone, SNNPR, Ethiopia. Arch Med 2015; 7(4): 8.
[17]
Kamel A, Mayuranathan L. Multiple repeat caesarean section in the UK: Incidence and consequences to mother and child. A national, prospective cohort study. BJOG 2013; 120(9): 1154-5.
[http://dx.doi.org/10.1111/1471-0528.12231] [PMID: 23837780]
[18]
Kennare R, Tucker G, Heard A, Chan A. Risks of adverse outcomes in the next birth after a first cesarean delivery. Obstet Gynecol 2007; 109(2 Pt 1): 270-6.
[http://dx.doi.org/10.1097/01.AOG.0000250469.23047.73] [PMID: 17267823]
[19]
Smith GC, Pell JP, Dobbie R. Caesarean section and risk of unexplained stillbirth in subsequent pregnancy. Lancet 2003; 362(9398): 1779-84.
[http://dx.doi.org/10.1016/S0140-6736(03)14896-9] [PMID: 14654315]
[20]
Nisenblat V, Barak S, Griness OB, Degani S, Ohel G, Gonen R. Maternal complications associated with multiple cesarean deliveries. Obstet Gynecol 2006; 108(1): 21-6.
[http://dx.doi.org/10.1097/01.AOG.0000222380.11069.11] [PMID: 16816051]
[21]
Munir SS, Amin D, Sultana M. Safety of high order caesarean section. Pak J Med Health Sci 2011; 5: 55-9.
[22]
Zwergel C, Von Kaisenberg C. Maternal and fetal risks in higher multiple cesarean deliveries. Recent advances in cesarean delivery. Intechopen 2019.

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