The Relevance of the Second Cesarean Delivery in the Reduction of Institutional Cesarean Delivery Rates

Abstract

Objective: The cesarean delivery rate has increased worldwide. The aim of our study was to assess the events associated with the second cesarean deliveries in our institution. Subjects and Methods: All cesarean deliveries at the Maternity Hospital, Kuwait, from January 1 to December 31, 2013, were identified. A comparative study was undertaken on patients having their first and second cesarean deliveries. The social and clinical characteristics of these patients were extracted from our records and the antenatal, intrapartum, and postpartum course of the pregnancies and their outcomes documented. Results: During the study period, 10,586 deliveries were recorded, including 3,676 cesarean deliveries, i.e., a cesarean delivery rate of 34.7%. 840 of these patients were undergoing their first cesarean delivery (group A) and 607 patients were undergoing their second (group B); 484 patients from group A and 341 patients from group B with complete records were analyzed. Mean age (30.89 ± 4.93 vs. 29.94 ± 5.56 years, p = 0.008), parity (1.49 ± 1.22 vs. 0.98 ± 1.60, p < 0.0001), gestational age at delivery (38.12 ± 2.61 vs. 37.66 ± 3.11 weeks, p = 0.02), and fetal birth weight (3,211.60 ± 691.51 vs. 2,829.73 ± 863.26 g, p < 0.001) were significantly higher in group B than in group A. 53.2% of the patients in group B requested repeat cesarean delivery, their second cesarean. The rate of maternal morbidity was low. Conclusions: The incidence of repeat cesarean delivery in group B is high, and its reduction should contribute to a lowering of the overall cesarean delivery rate.

Comparative study between cases of previous one cesarean section delivered at Kafr El-Sheikh hospitals, versus those delivered at Tanta Uniersity Hospital

“…8 Also, Diejomaoh et al reported that the mean gestational age at delivery was 38.12±2.61 weeks in second caesarean section. 9 In agreement with or findings, Kafali et al conducted a study with 150 women in order to evaluate the effect of chewing gum after caesarean section on postoperative bowel activity and bowel sounds as reported similar results in their groups (5.9 hours) after gum use and 6.7 hours in the control group (p<0.01). 10 Similar results were reported by the study of Maeboud et al with 200 women after caesarean delivery under general anesthesia in Egypt revealed that patients experienced bowel sounds 10.9 hours after surgery.…”

Comparison of anesthesia professionals' preferences of delivery method with other health professionals

“…As a preference of pregnant women or obstetricians, selection of the cesarean method is still high in deliveries after the cesarean deliveries. In their study on the first and second cesarean deliveries, Diejomaoh et al found the general cesarean delivery rate as 34.7% in their studies on first and second cesarean births, and stated that the previous delivery method played an important role in decreasing the high cesarean rates [11]. As it is understood from here, in order to decrease the cesarean rate, it is necessary to conduct studies that focus on the first delivery method of pregnant women.…”

Long Term Effect of Mode of Delivery on Sexual Function: A cross-Sectional Study

“…Possible causes of cesarean delivery on maternal request may be the fear of sexual dysfunction due to the loss of vaginal muscle tone [14] . The absence of genital tract trauma in cesarean delivery was proposed to preserve postpartum sexual function [15] . Many trials blamed vaginal delivery for pelvic floor disorders after delivery [16][17][18] .…”