Authors' response to: Multiple repeat caesarean section in the UK: incidence and consequences to mother and child. A national, prospective cohort study

Abstract

References

Maternal and Fetal Risks in Higher Multiple Cesarean Deliveries

“…The results of the trials show ( Table 1) that the quantity of any blood transfusion and also the rate of ICU admission are higher in the first cesarean section on the one side and in the higher order repeat cesarean section (≥4) on the other side than the number of transfusion in the second and third cesarean sections [3,5,10,11,13,14]. The increased number of blood transfusions and lengthened intensive care hospitalization following the first cesarean section may be explained by the fact that in this cohort, emergency deliveries and more unexpected situations are included, compared with the cohort of the elective second or third cesarean sections.…”

“…[30] 0.72% n = 372/50,685 [30] 0.19% n = 42/50,685 [30] 1.21% n = 358/50,685 [30] Second CS -0.61% n = 52/8542 [3,8,12] 0.43% n = 75/17,378 [3,8,10,11] 1.58% n = 273/17,280 [3,5,10,11] VBAC 2 71.70% n = 4064/5666 [30] 1.36% n = 74/5421 [30] 0.56% n = 14/2512 [30] 2.01% n = 39/5666 [30] Third CS -3.71% n = 29/782 [3,8] 0.91% n = 65/7106 [3,8,10,11] 2.23% n = 157/7050 [3,5,10,11] VBAC > 2 79.7 7 % n = 71/89 [31] 0.00% n = 0/89 [31] n.k. 2.20% n = 2/89 [31] ≥4 CS -4.34% n = 41/945 [3,4,8,13] 2.49% n = 66/2652 [3,8,10,11,13] 5.35% n = 142/2652 [3,5,10,11,13,14] VBAC1/VBAC2 = vaginal birth after one/two cesarean sections; CS = cesarean section…”

Contribution of antepartum and intrapartum hemorrhage to the burden of maternal near miss and death in a national surveillance study

“…Up to 90% of patients with placenta accreta variations require transfusion therapy and maternal mortality is elevated . An increased risk of bleeding due to placenta accreta during delivery has been observed even in high‐income countries and is related to the increase in cesarean deliveries .…”

Optimizing the use of Cesarean Section in Argentina: Design and Methodology of a Formative Research for the Development of Interventions

“…Cesarean section is a surgery that is used to solve or prevent certain complications that occur during pregnancy or childbirth and to reduce health risks for women and newborns. However, like any surgical procedure, cesarean section presents some risks and its use implies greater costs for health systems [3,4,5]. The inappropriate use of this intervention is a cause of concern given the fact that, as in highly vulnerable social contexts some women do not have access to a cesarean section and in others it is unnecessarily used, it increases inequalities in the access to and use of health interventions in the population.…”