Complications of caesarean section

Abstract

Key content The incidence and presentation of complications of caesarean section. The surgical management of intrapartum and postpartum haemorrhage. Risk factors for, and prevention and treatment of postpartum sepsis. Presentation, investigation and repair of bladder injuries when recognised intraoperatively and following delayed presentation. Risk factors for, and recognition and management of suspected ureteric injury intraoperatively and postoperatively. Bowel complications including intraoperative bowel injury and management, postoperative ileus and Ogilvie syndrome. Particular risks and complications associated with caesarean section at full dilatation. Caesarean section in the developing world. Learning objectives To be aware of the most common and serious complications of caesarean section. To be able to describe recognition and initial surgical management of suspected bladder, ureteric and bowel injuries. To be familiar with delayed presentations of visceral injuries and have a systematic approach to investigation of suspected injury. To understand the impact of caesarean section complications in resource‐poor countries. Ethical issues Appropriate, accurate preoperative counselling regarding risks and consent. Awareness of personal competency in managing specific complications.

Complications of Cesarean Operation

“…In developing countries, obstetric hemorrhage alternates the first and second position with preeclampsia as a cause of maternal death, and the World Health Organization accepts a rate of 10% worldwide in all births with live fetus [3,4,[14][15][16][17][18][19][20][21].…”

“…This increase is also favored by non-professional communication in social networks that minimize the surgical risks of cesarean section, promoting false advantages aimed mainly at family comfort; as well as by health professionals not related to obstetrics and although it bother us to recognize it, also by some "obstetricians" who seek personal benefits [1][2][3][4][5][6][7][8][9][10][11].…”

“…In 2016, it had been 100 years since Edward Craigin suggested that "once a cesarean, always cesarean," a concept that not only continues in many obstetricians but also becoming increasingly popular, so that the same patients increasingly request a cesarean section of repetition without considering the reproductive impact that it entails and without a full knowledge of the possible complications that even in our days have a considerable risk of high morbidity and mortality, both maternal and fetal [1][2][3][4][5][6][7][8][9][10].…”

Risk factors for Caesarean delivery after induction of labour among nulliparous women at term

“…Nulliparous women have an increased risk of Caesarean delivery after induction of labour 3,4 . Caesarean section is associated with short-term and long-term complications such as postpartum haemorrhage, morbid adherence of placenta, and uterine rupture in future pregnancies [5][6][7] . Risk factors for Caesarean delivery after induction of labour include nulliparity, more advanced maternal age, greater body mass index, hypertension, and diabetes [8][9][10][11][12] .…”

Factors Associated with the Type of Cesarean Section and the Risk of Postoperative Complications in Greek Women

“…Cesarean Section (CS) rates have been increasing in recent decades worldwide, and this is a global problem because of the negative effect on maternal and neonatal health [ 1 ]. Although CS is a very common surgery, it is associated with an increased risk of hemorrhage, uterine bladder and bowel injury, postoperative sepsis, postoperative ileus [ 2 ] and thromboembolic events [ 3,4 ]. Some studies on neonatal complications have shown that CS is associated with an increased risk for the infant's obesity, diabetes, respiratory morbidity, and atopic dermatitis in childhood [ 5 , 6 ].…”