Complications associated with higher order compared to lower order cesarean sections

Abdelazim, Ibrahim A.; Alanwar, Ahmed; Shikanova, Svetlana; Kanshaiym, Sakiyeva; Farghali, Mohamed M.; Mohamed, Mohamed; Zhurabekova, Gulmira; Karimova, Bakyt

doi:10.1080/14767058.2018.1551352

Cited by 24 publications

(25 citation statements)

References 25 publications

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“…Most of the relevant studies identified a significant difference in both bladder and bowel injuries between lower and higher order elective repeat cesarean section [3][4][5][6][7]. Particularly after more than three prior cesarean sections, the risk of any injury rises substantially [15]. This common finding is probably due to the higher rate of severe adhesions after higher order multiple repeat cesarean section.…”

Section: Urological and Intestinal Injurymentioning

confidence: 99%

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Maternal and Fetal Risks in Higher Multiple Cesarean Deliveries

Zwergel¹,

Kaisenberg²

2020

Recent Advances in Cesarean Delivery

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The professionalization of women has shifted family planning to increased maternal ages. This has increased the use of assisted reproduction. Therefore, the tolerance toward suboptimal outcome of pregnancy decreases, and self-determined decision-making is on the rise. Once women have made the decision for elective cesarean section in their first pregnancy, subsequent pregnancies may result in multiple cesarean deliveries. This chapter analyzes the risks associated with higher multiple cesarean deliveries, such as bleeding and transfusion, adhesions, bowel and urinary tract injury, and uterus rupture. It also discussed the risks for vaginal birth following cesarean (VBAC) following multiple cesareans. Also there are neonatal risks involved, and women may require specific obstetric anesthesia. The chapter will analyze the risks for the offspring and the mother depending on the number of previous cesarean sections. This may enable detailed counseling of parents before a higher multiple repeat cesarean section is performed.

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Section: Urological and Intestinal Injurymentioning

confidence: 99%

“…Some of the analyzed studies pointed out that there is a significant higher rate of blood loss or any blood transfusion especially in the group of more than three repeat cesarean sections [3,7,13,15,18]. This may be due to a higher rate of adhesions, visceral injury, and possibly abnormal placentation (see also 3.4.).…”

Section: Hemorrhagementioning

confidence: 99%

Maternal and Fetal Risks in Higher Multiple Cesarean Deliveries

Zwergel¹,

Kaisenberg²

2020

Recent Advances in Cesarean Delivery

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“…More than 80% of obstetric hemorrhages occur postpartum (PPH) and are responsible for 25% of maternal deaths each year 3. Cesarean section is also identified as an important cause of PPH, carrying risk for major intraoperative blood loss 4. In obstetric practice, this makes cesarean section an important indicator for blood transfusion.…”

Section: Introductionmentioning

confidence: 99%

“…The risk of transfusion increases as the number of cesarean section s increases. Abdelazim I et al, found that risk for blood transfusion increased 4.7%, in women having more than three Cesarean sections 4. However, preparing cross-matched blood in anticipation not only causes an economic burden but also scarcity of blood especially in a developing country like Pakistan.…”

Section: Introductionmentioning

confidence: 99%

Blood transfusion and high-order cesarean delivery; Report from a developing country

et al. 2019

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Background and Objective: Blood loss in cesarean deliveries has already been established in previous researches but a detailed insight into the correlates has not been done. This study examined whether the number of previous Cesarean sections is related to the need for blood transfusion, and risk factors for blood transfusion. Methods: A retrospective review of 239 females who had undergone two or more Cesarean sections during the time period of 2015-2018 was done. Data collected included type of surgery (elective or emergency), age, parity, body mass index, estimated blood loss, operating time, level of surgeon, presence or absence of adhesions and number of transfused packed cell volume. Results: About 9.2% patients received blood transfusion with an estimated average blood loss of 618.18 ml. Patients with adhesions from previous surgery, presence of placenta previa, multiparity were significantly likely to receive blood transfusion. It was found that women with more than two caesarian sections had high proportion of blood transfusion as compared to women who had two caesarian sections. However non-significant difference was observed in numbers of caesarean sections with blood transfusion. Conclusion: Women undergoing Cesarean sections combined with any of the risk factors like increased body mass index, dense adhesions, uterine atony, hypertension and presence of placenta previa, were found to be at increased risk for a need for blood transfusions. doi: https://doi.org/10.12669/pjms.35.6.539 How to cite this:Abbas S, Mughal S, Hussain SNF, Hossain N. Blood transfusion and high-order cesarean delivery; Report from a developing country. Pak J Med Sci. 2019;35(6):1520-1525. doi: https://doi.org/10.12669/pjms.35.6.539 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…In a recent statement, WHO corroborates that CS, as a major abdominal surgery, is effective in terms of reducing maternal and perinatal morbidity and mortality, but only when medically indicated 7 . Considering the adverse effects of CS for the mother and newborn in a subsequent pregnancy, such as higher potential for repeat CS, abnormal placentation, stillbirth, preterm birth, and high blood loss, 11 the benefit–risk balance remains poor for CS without medical indications 12,13 . However, the reasons of the global increase in CS are multifactorial and include medical as well as non‐medical aspects such as personal, cultural, institutional, legal, and financial factors.…”

mentioning

confidence: 99%

Differences in rate and medical indication of caesarean section between Germany and Japan

Fröhlich

Koga

Bührer

et al. 2020

Pediatrics International

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Background: There are growing concerns about the increasing rate of caesarean section (CS) worldwide. Various strategies have been implemented to reduce the proportion of CS to a reasonable level. Most research on medical indications for CS focuses on nationwide evaluations. Comparative research between different countries is sparse. The aim of this study was to evaluate differences in the rate and indications for CS between Japan and Germany in 2012 and 2013. Methods: Comparison of the overall rate and medical indications for CS in two cohort studies from Germany and Japan. We used data from the German Perinatal Survey and the Japan Environment and Children's Study (JECS). Results: We analyzed data of 1 335 150 participants from the German perinatal survey and of 62 533 participants from JECS and found significant differences between the two countries in CS rate (30.6% vs 20.6%) and main medical indications: cephalopelvic disproportion (3.2% vs 1.3%; OR: 2.4 [95% CI: 2.2-2.6]), fetal distress (7.3% vs 2.3%; OR: 3.4 [95%-CI: 3.2-3.6]), and past uterine surgery/repeat CS (8.4% vs 8.8%; OR: 0.9 [95%-CI: 0.9-1]). Conclusion: There are differences in the rate and medical indications for CS between Germany and Japan at the population level. Fetal distress was identified as a medical indication for CS more often Germany than in Japan. Considering the substantial diagnostic uncertainty of electronic fetal monitoring (EFM) as the major indicator for fetal distress, it would seem to be reasonable to rethink CS decision algorithms.

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Complications associated with higher order compared to lower order cesarean sections

Cited by 24 publications

References 25 publications

Maternal and Fetal Risks in Higher Multiple Cesarean Deliveries

Maternal and Fetal Risks in Higher Multiple Cesarean Deliveries

Blood transfusion and high-order cesarean delivery; Report from a developing country

Differences in rate and medical indication of caesarean section between Germany and Japan

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