Outcomes of women age 40 or more undergoing repeat cesarean or trial of labor after cesarean

Cesarean Section Complications Followed by Bladder Cystotomy and Gross Hematuria Due to Unknown Dense Scar Tissue

“…As the population of older women pursuing pregnancy grows, the data demonstrates strengthening and clear relationships between advanced maternal age and intra- and peripartum complications involving both the mother and fetus. A study of over 60,000 mothers, 2,436 who were over age 40, found a higher rate of transfusions of packed red blood cells (PRBCs), maternal ICU admission, bowel injury, placenta accreta, and use of classical uterine incision compared to the control group [ 2 ]. A multivariate analysis study found maternal age greater than 40 to be an independent risk factor for preterm delivery, Cesarean section, abnormal fetal presentation, and fetal periventricular leukomalacia [ 8 ].…”

“…Women aged ≥40 undergoing Cesarean deliveries are more likely to have complications compared to women <40. Those issues include a 75% increase in intraoperative transfusion, 38% increase in postpartum transfusion, three times increase in bowel injury, 92% increase in abnormal placentation, 59% increase in the classical incision, and two times increase in Cesarean hysterectomy and maternal intensive care unit (ICU) admission [ 2 ]. In addition, pregnancy outcomes at very advanced maternal age have a higher rate of maternal complications such as gestational hypertension, preeclampsia, gestational diabetes, increased need for blood transfusion, and prolonged hospitalization [ 3 ].…”