RESUMO
Objective: to determine the maternal morbidity and mortality associated with multiple repeat caesarean Section
Study Design: retrospective study
Place of study: federal Postgraduate Medical Institute and Shaikh Zayed Hospital, Lahore
Population: total 179 case record, 92 cases of previous one, 61 cases of previous two c-section, and 26 cases of previous three c-section, studied during the period of one year i.e 1/1/2006 to 3 1/12/2006
Main outcome: operative and post operative complications and difficulties
Results: out of 179 cases, 135 were elective and 44 emergency scar. Dehiscence was seen in 23 cases. Duration of operation was high with increasing rates of c-section. Maximum 3 hour, ICU care in only 1 patient. Only one caesarean hysterectomy because of bladder injury needed 6 units of blood i.e. no maternal mortality. One baby was IUD
Conclusion: higher order c-section is not a serious threat to mother and baby provided there is optimal antenatal care, counselling, adequate pre and post operative care, meticulous surgical technique, but patient must be made aware of the risks of operative delivery and frequently repeated pregnancy