Pregnancy outcomes of multiple repeated cesarean sections in King Chulalongkorn Memorial Hospital.

ABSTRACT

OBJECTIVES: To determine the incidence of maternal and neonatal morbidity and mortality in women with history of at least one previous cesarean section and to compare the pregnancy outcome of the women with the history of one previous cesarean section to the women with the history of two or more previous cesarean section. MATERIAL AND METHOD: We performed a retrospective study of 458 patients undergoing repeated cesarean section from 1998 to 2005. Various factors that may be associated with repeated cesarean sections and pregnancy outcomes were assessed and analyzed. RESULTS: Maternal morbidity rate was 18.6%, including operative complications (17.5%) and post operative complications (1.7%). The operative complications included intraperitoneal adhesion 45 cases (9.8%), excessive blood loss (> 1000 ml) 29 cases (6.3%), placenta previa 5 cases (1.1%), placenta adherens 6 cases (1.3%) and requirement of blood transfusion 10 cases (2.2%). Postoperative complications included postpartum hemorrhage 4 cases (0.9%). No maternal mortality was found in this study. Neonatal morbidity rate was 20.5%, including neonatal jaundice 33 case (7.20), large for gestational age 37 cases (8.1%), and preterm babies 20 cases (4.4%). There were no statistically significant differences of maternal morbidity and neonatal morbidity between the pregnant women with the history of one previous cesarean section and the women with the history of two or more previous cesarean section. CONCLUSIONS: Maternal and neonatal morbidity in repeated cesarean section were low.