The Study of Intra-Operative Difficulties in One Repeat Caesarean Section Compared with Two or More Caesarean Sections

Abstract

BACKGROUND Most commonly done obstetric procedure globally is caesarean section. The incidence of C-section is continuously increasing because risk associated with vaginal delivery after caesarean, previous caesarean section is an important indication for Csection. The purpose of this study was to assess the difficulties during intra-operative period in women who undergo caesarean section repeatedly and also to study the comparison between difficulties with women with previous one caesarean section and women with previous 2 or more C-sections. METHODS It is a prospective observational study conducted on 150 women in the Department of Obstetrics & Gynaecology in Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar in women with history of previous caesarean sections (one or more). The women were divided into two groups - Group 1 - Those with previous one caesarean section and Group 2 - Those with previous two or more caesarean sections. RESULTS Out of 150 cases randomly selected and studied who had repeated caesarean section,90 had 1 previous lower segment caesarean section (LSCS), 60 had two or more caesarean sections, the highest number of caesarean sections were performed on women between the age group of 20 - 29 years. Out of these, some cases did not show intra-operative complications, some showed variety of intra-operative complications. Most common type of complications that they came across were adhesions (44 %) in 1 previous LSCS, 65 % in 2 or more LSCS. There were no cases of scar rupture, uterine rupture, bowel injury, caesarean hysterectomy in the study population, probable reason could be that cases were taken elective or taken with a short trial of labour with high level of intrapartum monitoring. CONCLUSIONS Higher incidence of intra-operative complication is seen in women with previous caesarean sections. KEY WORDS Repeat C - Section, Adhesions, Intra-operative Complications

Prevalence and risk factor of postoperative adhesions following repeated cesarean section: A prospective cohort study

“…The current study reported that women with dense adhesions had higher numbers of previous cesarean deliveries and a history of abdominal surgery; however, a significant correlation was not reported. This agreed with the results of earlier studies, where repeat cesarean deliveries were associated with increased intraperitoneal adhesions 33,34 . Additionally, raised, keloid, and dark red scars were associated with dense intraperitoneal adhesions; however, a significant correlation was lacking.…”

“…This agreed with the results of earlier studies, where repeat cesarean deliveries were associated with increased intraperitoneal adhesions. 33,34 Additionally, raised, keloid, and dark red scars were associated with dense intraperitoneal adhesions; however, a significant correlation was lacking. Conflicting results are present regarding this issue.…”