Multiple repeat caesarean deliveries: do they increase maternal and neonatal morbidity?

Tunç, Senem Yaman; Sak, Sibel; Başaranoğlu, Serdar; Görük, Neval Yaman; Turgut, Abdülkadir; Tay, Hayrettin; Elçi, Evindar; Gül, Talip

doi:10.1080/14767058.2016.1183638

Cited by 17 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In some studies, it was observed that the increase in the number of cesarean deliveries did not increase neonatal risks [10,30]. In other studies, the neonatal risk increased as the number of CDs increased [17,24]. In our study, fetal umbilical artery pH was found to be lower in the group with four or more CDs in terms of fetal birth weight, meconium presence, fetal anomalies, and APGAR score (p = 0.003).…”

Section: Discussionsupporting

confidence: 58%

“…Ozcan et al [24] found that there was a significant correlation between the increase in cesarean number and bowel injury , but they did not find its relationship with bladder injury. In the study conducted by Tunc et al [23], a statistically significant increase was found in the group that had their second CD, but no increase in the risk of linearity was observed as the number of CDs increased. The incidence of bowel, bladder and ureteral ligation was very rare and there was no significant difference between the groups.…”

Section: Discussionmentioning

confidence: 97%

“…Adhesion may prolong the duration of the operation and may cause bladder or bowel injury, increased bleeding and delayed delivery of the fetus [14][15][16]. In many studies, the relationship between the frequency of CD and adhesion has been observed [6,10,13,17]. In one study, the rate of adhesion was determined as 7% in primary CD, whereas 65% in those with three CDs [18].…”

Section: Discussionmentioning

confidence: 99%

“…Some of the studies did not show any increase in damage [10,13], whereas some showed only bladder damage [23], some showed intestinal damage [24], and some showed damage in both [6,25]. It has been observed that these risks did not show a linear increase with the rise in the number of CDs for the majority of the studies in which the risk of bladder and intestinal injury was significant [6,23]. Ozcan et al [24] found that there was a significant correlation between the increase in cesarean number and bowel injury , but they did not find its relationship with bladder injury.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

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

Çintesun

2017

Ginekol Pol

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Çintesun

2017

Ginekol Pol

View full text Add to dashboard Cite

show abstract

“…assessed two groups of nulliparous women at an early stage of prenatal care: one group with a previous abortion using a mifepristone–misoprostol regimen and complementary curettage when necessary (n=4673), and one group with no abortion (n=4690). The adjusted OR for placenta accreta was 1.16 (95% CI, 0.65–2.08) …”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐analysis of cesarean delivery and other uterine surgery as risk factors for placenta accreta

Mucio¹,

Serruya²,

Alemán

et al. 2019

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Background The incidence of placenta accreta has increased in recent years and it has been suggested that the rising trend in cesarean delivery and other uterine surgery is the underlying cause. Objective To explore the magnitude of the effect of performing single and repeat cesarean deliveries or other uterine surgery on the incidence of placenta accreta. Search strategy Relevant databases were searched for papers published before August 1, 2018, using terms including “accreta” and “cesarean.” Selection criteria Cohort studies assessing the risk of placenta accreta according to women's history of uterine surgery. Data collection and analysis Meta‐analyses were performed to assess the risks associated between uterine surgery and placenta accreta, hysterectomy, and uterine rupture. The I2 statistic was used to examine between‐study heterogeneity. Main results The risk of placenta accreta in a second pregnancy increased for women who had undergone a cesarean in their first pregnancy compared with vaginal delivery (OR 3.02; 95% CI, 1.50–6.08). Absolute risk of placenta accreta increased with the number of previous cesareans. The risk of uterine rupture and hysterectomy was also associated with the number of cesareans. Conclusions Risk of placenta accreta, hysterectomy, and uterine rupture increases with the number of previous cesarean deliveries. PROSPERO: CRD42016050646.

show abstract