An analytical study of intraoperative, immediate post-operative and perinatal complications in previous two caesarean section

Abstract

Background: Lower segment caesarean section is one of the commonest operations performed now a day.It has been seen that in cases with previous caesarean section there is increased maternal morbidity and mortality due to placenta previa, adherent placenta and caesarean hysterectomy.The present study was conducted to know the fetomaternal outcome and intra and immediate post-operative complications in cases with previous two lower segment caesarean section.Methods: The present study was conducted in TMMC Moradabad between January 2017-January 2018.Total 68 cases were previous two lower segment caesarean section were included in the study. Neonatal outcome and intraoperative and immediate postoperative complications were seen in these cases.Results: In the present study majority of the cases were in 30-34 years age group (39.7%), the maximum number of caesarean sections were done between gestational age of 37-39.6 weeks (47.1%). Intraoperatively adhesions between uterus, anterior abdominal wall and bladder was seen in less than half of the cases i.e. in 42.6% cases. Out of 68 cases with previous two lower segment caesarean operated 13 cases had placenta previa and 4 cases had adherent placenta.Conclusions: The present study shows that the maternal and perinatal morbidity and mortality is increased with increasing number of caesarean sections. So, there should be reduction in rate of primary caesarean section which can reduce the rate of placenta previa and adherent placenta in subsequent pregnancies.

Determinants of primary vs previous caesarean delivery in a tertiary care institution in Kerala, India

“…There were twice the number of babies with <2.5 kg in primary caesarean group. Majority of the neonates in Singh P et al [28] ~ 235 ~ had birth weight between 2.5 to 3 kgs (45.6%) similar to the present study. Low birth weight babies were 1.65 more in primary caesarean group and statistically significant.…”

“…Gestational age at caesarean delivery 29.04% births were before <37 weeks of gestation in both groups while 43.6% of previous 2caesareans were decided at the same time frame in Singh P et al [28] AIP (Abnormally invasive placentation) Diagnosis of placenta accreta before delivery allows multidisciplinary planning to reduce the potential maternal or neonatal morbidity and mortality [29][30] . Out of 155 cases of previous caesarean operated, 4 cases had placenta previa and 3 cases had adherent placenta.…”