Uterine Scar Condition and Complications Associated with Repeat Caesarean Section: A study in a Tertiary Care Hospital

Abstract

Introduction: Lower segment cesarean section is the commonest surgical procedure in obstetrics. Repeating a cesarean section in subsequent pregnancies is the usual method of termination which involves many complications. Our objective was to study these complications and difficulties observed in a repeat cesarean section. Material and methods: It was a prospective observational study of 241 cases of repeat cesarean section from October 2017 to September 2018 in department of obstetrics and gynecology of Hi-Tech medical college and hospital, Bhubaneswar, odisha. Results: In this study, total 1610 patients are taken. Among these most common indication for cesarean section is CPD i.e56 (23%).Most common incidence of intraoperative complication of previous cesarean section is adhesion i.e. 124(51.61%). Conclusion: Maternal morbidity is a cause of concern in repeat cesarean section because of the intraoperative complications encountered during surgery and thereafter. Reduction in primary caesarean rate can reduce the complications. Patients with previous cesarean section are categorized as high risk and counselled for VBAC in suitable cases.

The maternal and fetal outcome of repeat previous one caesarean section

“…Our study was not in agreement with other studies in which the success rate of VBAC was 67.6%, 60% and 63.5% respectively. [16][17][18] In our study delivery rate after VBAC was higher in patients with inter delivery interval of more than 24 months.…”

“…In the study of Singh et al low-birth-weight babies were 2.5%, admission in NICU was 2.2%, Apgar score<7 at 5 minutes was 2.2% transient tachypnea of newborn was 1.04%, neonatal sepsis was found in 2.5% cases and there was no stillbirth. 16 In the study of Bailit et al NICU admission was 19.3% cases and neonatal death was 0.3% of cases. 28 In the study of Anagha et al perinatal morbidity was higher in cases of repeat caesarean section.…”

“…31 In the study of Singh et al uterine atony was reported 3.5% of cases. 16 Caesarean hysterectomy in 0.7% of the study population. 16 In the study of Bhowmik et al PPH was found in 6.6% of cases, followed by wound extension (3.3%) of cases.…”

“…16 Caesarean hysterectomy in 0.7% of the study population. 16 In the study of Bhowmik et al PPH was found in 6.6% of cases, followed by wound extension (3.3%) of cases. 27 In the study of Goel et al, PPH was in 48.55% cases which were quite high.…”