open access

Vol 88, No 11 (2017)
Research paper
Published online: 2017-11-30
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The effect of increased number of cesarean on maternal and fetal outcomes

Ersin Çintesun1, Ragıp Atakan Al2
DOI: 10.5603/GP.a2017.0110
·
Pubmed: 29303215
·
Ginekol Pol 2017;88(11):613-619.
Affiliations
  1. Selcuk University, Faculty of medicine, Department of Obs&Gyn, 42030 Konya, Turkey
  2. Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey

open access

Vol 88, No 11 (2017)
ORIGINAL PAPERS Obstetrics
Published online: 2017-11-30

Abstract

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.

Abstract

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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Keywords

cesarean delivery, intraoperative complications, morbidity, postoperative complications Ginekologia Polska 2017; 88

About this article
Title

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

Journal

Ginekologia Polska

Issue

Vol 88, No 11 (2017)

Article type

Research paper

Pages

613-619

Published online

2017-11-30

DOI

10.5603/GP.a2017.0110

Pubmed

29303215

Bibliographic record

Ginekol Pol 2017;88(11):613-619.

Keywords

cesarean delivery
intraoperative complications
morbidity
postoperative complications Ginekologia Polska 2017
88

Authors

Ersin Çintesun
Ragıp Atakan Al

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