Are multiple repeated cesarean sections really as safe?

Uyanıkoğlu, Hacer; Karahan, Mahmut Alp; Turp, Ahmet Berkız; Agar, Mehmet; Tasduzen, Mehmet Emin; Sak, Sibel; Sak, Muhammet Erdal

doi:10.1080/14767058.2016.1175426

Cited by 14 publications

(24 citation statements)

References 12 publications

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“…Researchers have addressed the close relationship between the increased number of CD's and maternal morbidity [6][7][8][9]. Some others have suggested that increased CDs do not put an additional risk for maternal and fetal morbidity [10,11]. In our study, mild maternal morbidity was found to be significantly higher in the group of patients with four or more CDs, whereas severe maternal morbidity did not have significant effect on visceral organ injury.…”

Section: Discussionsupporting

confidence: 35%

The effect of increased number of cesarean on maternal and fetal outcomes

Çintesun

2017

Ginekol Pol

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Objectives: The aim of this study was to evaluate the effects of multiple cesarean deliveries (CDs) on maternal-fetal morbidity and mortality rates. Material and methods:This retrospective study included a total of 1,506 patients who underwent multiple CDs between January 2006 and May 2014. The patients were divided into two groups. One group consisted of patients with four or more CDs (n = 444) and a control group of patients with three CDs (n=1,062). Both groups were analyzed for demographics, complications from multiple cesarean deliveries and perinatal outcomes. Results:The mean age was higher in the study group (p < 0.001). Dense adhesion (p < 0.001), demand for tubal ligation (p < 0.001), the requirement of pelvic drainage (p < 0.001), duration of hospitalization (p < 0.001) and the requirement for blood transfusion (p=0.03) was also significantly higher in the study group. Hemoglobin levels (p = 0.002) were significantly higher in the control group on the second postoperative day. Regarding perinatal morbidity; umbilical artery pH results (p = 0.003) were significantly lower in the study group. There was no significant difference in the maternal and fetal mortality rates between both groups.Conclusions: According to our study results, an increase in the number of cesarean sections increases maternal and fetal morbidity rates significantly. Therefore, we recommend decreasing the rate of primary cesarean deliveries by encouraging vaginal birth after CD. We also advocate the use of permanent contraceptive methods in patients with a high number of CD's. Further large-scale prospective results are required to establish a definitive conclusion.

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Section: Discussionsupporting

confidence: 35%

The effect of increased number of cesarean on maternal and fetal outcomes

Çintesun

2017

Ginekol Pol

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“…Conversely, it has been defined that nulliparous mothers had an increased risk of preterm birth and preeclampsia compared to multiparous women (15). In the present study, women who had 4 or more CS were older and had higher gravidity (31.5±4.9 and 4 [4][5][6][7][8], respectively) than the controls who had two or less CS (28.2±4.4 and 3 [2][3][4][5][6][7][8][9][10][11][12], respectively) (p<0.001). Preoperative hematocrit values were significantly lower in study group compared to control group.…”

Section: Discussionmentioning

confidence: 72%

“…There has been a significant increase in the CS rate in Turkey as in world-wide (9). Previously in the literature, it has been shown that repeated cesarean birth was related to serious maternal and fetal complications when compared to normal birth and the first CS (10) and need for the blood transfusion in women who had four or more CS compared to controls who had one or two prior CS.…”

Section: Discussionmentioning

confidence: 99%

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Four or More Cesarean Sections, is it Still Safe?

Yücel

Kadiroğullari²,

Karahasan³

et al. 2017

Gynecol Obstet Reprod Med

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OBJECTIVE:We aimed to compare the maternal and neonatal complications in women who had undergone fourth or more cesarean section with to women who had undergone second or third cesarean section.STUDY DESIGN: 162 women who had four or more cesarean section (study group) and 228 women who had undergone second or third cesarean section (control group) were reviewed retrospectively. Demographic features, obstetric, intraoperative, postpartum and neonatal complications were determined in both groups. RESULTS:The preoperative hematocrit values were lower in study group (35.6±3.6) than the control group (36.6±4.3), (p<0.001). Patients with four or more cesarean sections had an increased rate (24.7%) of intra-abdominal dense adhesions compared with the controls (14.9%), (p<0.001). Blood transfusion rate was higher in the study group (8.6% to 3.5%, p=0.043). Except these; frequencies of obstetric, intraoperative, postpartum and neonatal complications were similar between groups. CONCLUSION:We found that multiple CSs (four or more) do not increase the risk of maternal or neonatal complications except the rate of maternal anemia, dense adhesions and need for blood transfusion according to the results of our study. Fourth or more cesarean section appears to be still a safe procedure.

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“…It is postulated to be related to multiple risk factors including advancing maternal age (>35y), infertility treatment, muti-parity (5% in rad multiparous women), previous uterine surgery , uterine insult or injury, previous cesarean delivery (including first pregnancy following previous cesarean delivery, previous or recurrent abortions, or previous placenta previa In the current study, variable grades of PP were detected in 10 out of 20 PP group aged > 35 YO, with median age of 34YO , this proved to be statistically significant (P=0.024). Similarly, previous reports stated that increased maternal age, especially above 34 years old is associated with increased incidence of development of PP 11,13 .…”

Section: Discussionmentioning

confidence: 99%