scholarly journals Major risk factors of maternal adverse outcome in women with two or more previous cesarean sections

2016 ◽  
Vol 73 (8) ◽  
pp. 751-756
Author(s):  
Amira Egic ◽  
Natasa Karadzov-Orlic ◽  
Donka Mojovic ◽  
Zaga Milovanovic ◽  
Jovana Vuceljic ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Gestational Age ◽  
Maternal Morbidity ◽  
Adverse Outcome ◽  
Cesarean Sections ◽  
Maternal Complications ◽  
Cesarean Deliveries ◽  
Emergency Cesarean ◽  
Gestational Age At Delivery ◽  
Previous Cesarean

Background/Aim. Maternal morbidity is defined as any condition that is attributed to or aggravated by pregnancy and childbirth that has a negative impact on the woman's wellbeing. In recent years, a growing trend of cesarean section rates can be seen throughout the world. The aim of this study was to assess factors that might have major impact on maternal adverse outcome in women with two or more previous cesarean sections. Methods. This retrospective study included women with single term pregnancy after two or more cesarean deliveries in a 10-year period (2004?2013) in the University Clinic ?Narodni front? in Belgrade, Serbia. Medical records were reviewed for clinical data for maternal intraoperative and early postoperative complications regarding gestational age at delivery, the number of previous cesarean sections and mode of surgery (elective or emergency). Results. A total of 551 patients were included in the study. At 37 completed weeks delivered 14.1%, at 38 delivered 45.2% and at 39 completed weeks 40.7% patients. Women younger than 35 years more often delivered after 39 completed weeks compared with those over 35 years (69.2% vs 30.8%, p < 0.05). The overall rate of maternal complications in the study group was 16.5% with no statistical difference by gestational age at delivery. The overall rate of maternal adverse outcome was significantly less in the patients with three as compared with those with four or more cesareans (10.4% vs 66.7%, p < 0.05). There was a statistically significant difference between these groups of women regarding complications: scar dehiscence, the presence of adhesions, blood transfusion and admission in intensive care unit. Elective cesarean delivery was with less maternal complications compared with emergency cesarean deliveries (12.9% vs 27.3%, p < 0.05). Conclusion. Termination of pregnancy before completed 39 weeks does not decrease maternal morbidity. The major impact on maternal complications has the number of previous cesarean deliveries (? 3), as well as emergency cesarean section. Patients should be informed about potential risks for maternal health with increasing number of cesarean deliveries, especially after the first cesarean section when counseling in elective repeat cesarean vs trial of labor.

scholarly journals Study of feto-maternal outcome in previous cesarean section

2018 ◽  
Vol 7 (9) ◽  
pp. 3848
Author(s):  
Mahantappa A. Chiniwar
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Mode Of Delivery ◽  
Previous History ◽  
Clinical Findings ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Emergency Cesarean ◽  
Previous Cesarean

Background: There is increase in number of primary cesarean sections, leading to more number of women facing the issue of mode of delivery in the current pregnancy. There are reports about success of vaginal birth after cesarean section as well as complications such as scar dehiscence, rupture of uterus, poor maternal and fetal outcome.Methods: A prospective study was done for a period of 1 yr and 9 months at Cheluvamba Hospital attached to Govt Medical College Mysore from October 99 to June 2000. Data regarding previous cesarean section was collected, clinical findings during the present pregnancy were noted.Results: During the study period there were 942 women admitted with previous history of cesarean section. Elective repeat cesarean section was done for 530 cases and trial of labour after cesarean section was planned for 412 cases. Successful vaginal delivery was conducted in 311 cases. Repeat emergency cesarean section was done for 96 cases due to failed trial of labour. Maternal morbidity such as adhesions was seen in 11.25% and obliteration of U V fold in 7.92% of cases. Maternal mortality was seen in 0.15%. Perinatal morbidity was seen in 3.32%, perinatal mortality in 3.96%.Conclusions: With increasing proportion of women with previous cesarean sections, it is essential to counsel these women during trial of vaginal delivery in well equipped hospitals. It is worth to reduce primary cesarean section to avoid complications in consequent pregnancies. Proper and timely decision for repeat cesarean sections will reduce fetal and maternal morbidity and mortality.

scholarly journals Is emergency cesarean section more risky than elective cesarean section in women with previous cesarean section?

2018 ◽  
Vol 7 (5) ◽  
pp. 1880
Author(s):  
Balwan Singh Dhillon ◽  
Nomita Chandhiok ◽  
M. Vishnu Vardhana Rao
Keyword(s):  
Cesarean Section ◽  
Maternal Morbidity ◽  
Morbidity And Mortality ◽  
Previous Cesarean Section ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Maternal Morbidity And Mortality ◽  
Repeat Cesarean Section ◽  
Elective Repeat Cesarean ◽  
Previous Cesarean

Background: Cesarean section is one of the most performed surgical procedures all over the world, but unfortunately cesarean sections are associated with a great deal of maternal morbidity and mortality. In the past the rate of cesarean section has increased for many avoidable and unavoidable indications both in developed and developing countries. The objective of this study was to compare maternal morbidity and mortality in elective repeat cesarean section (El-RCS) and emergency repeat cesarean section Em-RCS.Methods: Prospective data was recorded on management practices, associated complications and morbidity and mortality on 15664 consecutive cases of previous cesarean section reporting at 30 medical colleges/teaching hospitals for delivery.Results: Of the 15664 women with a previous cesarean section, 5399 (34.5%) women underwent elective repeat cesarean section, 7752 (49.5%) women who underwent emergency repeat cesarean section and 2513 (16.0%) had successful trial of labor (S-TOL). There was    failed trial of labor (F-TOL) in 1522 cases and requiring an emergency cesarean section for delivery of baby. Therefore, total no. of 7752 women had an emergency cesarean section. The overall maternal morbidity was 22.5%, 20.7% in Em-RCS and El-RCS respectively. Blood loss was more than 1000ml in 7.2% of Em-RCS where as in El-RCS it was 8.8%, blood transfusion was 7.5% in Em-RCS where as it was 6.5% in El-RCS, dehiscence of scar in Em-RCS was 4.7% as compared to 2.2% in El-RCS, uterine rupture was 1.2% in Em-RCS as compared to 0.7 % in El-RCS found statistically significant. Post-operative complication was 5.9% cases in Em-RCS where as in El-RCS was 5.8% (p=0.79 non-significant). Maternal mortality was reported in 12 (0.2%) cases of Em-RCS as compared to 5 (0.1%) cases in El-RCS (p=0.37) which was not statistically significant.  Conclusions: Maternal morbidity was found more in emergency repeat cesarean section than in elective repeat cesarean section. Complications and referral of women who are likely to undergo cesarean section should be diagnosed at an early stage so that the maternal   morbidity and mortality can be prevented. 

Maternal morbidity with elective repeat cesarean section: The influence of the number of previous cesarean sections

2004 ◽  
Vol 191 (6) ◽  
pp. S153 ◽  
Author(s):  
Emmanuelle Pare ◽  
David Stamilio ◽  
Alison Cahill ◽  
Erika Stevens ◽  
Jeffrey Peipert ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Maternal Morbidity ◽  
Cesarean Sections ◽  
Repeat Cesarean Section ◽  
Elective Repeat Cesarean ◽  
Previous Cesarean

scholarly journals Lower-Segment Transverse Cesarean Section

2020 ◽  
Vol 06 (S 02) ◽  
pp. S72-S80 ◽  
Author(s):  
Yuji Hiramatsu
Keyword(s):  
Cesarean Section ◽  
Maternal Obesity ◽  
Present Report ◽  
Placenta Previa ◽  
Cesarean Sections ◽  
Abruptio Placentae ◽  
Uterine Myomas ◽  
Emergency Cesarean ◽  
Difficult Cases ◽  
Previous Cesarean

AbstractCesarean section is the ultimate method of successful delivery of infants under various circumstances and is an indispensable operation in obstetrics. However, the degree of difficulty varies greatly depending on the gestational weeks, number of fetuses, number of previous cesarean sections, degree of placental adhesion, presence of uterine myomas, maternal obesity, and other factors. In addition, emergency cesarean section is a battle against time, and prompt surgery is required.During training in cesarean section, surgeons must master the basic techniques in cases of term head presentation first. They must then master the techniques in cases involving complications such as malpresentation, preterm birth, placenta previa, abruptio placentae, uterine myomas, and other conditions.Cesarean section itself is a simple operation. However, there are many difficult cases, and many complications such as placenta accreta and defects of the incision scar may occur after cesarean section.The present report describes the basic procedures and cautionary points to perform the cesarean section without complications.

scholarly journals A study of rate, indications and maternal morbidity associated with cesarean delivery in a tertiary care hospital

2019 ◽  
Vol 8 (7) ◽  
pp. 2810
Author(s):  
Asma Nigar ◽  
Ausaf Ahmad ◽  
Khashia Khan
Keyword(s):  
Cesarean Section ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Morbidity And Mortality ◽  
Obstetrics And Gynecology ◽  
Care Hospital ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Previous Cesarean

Background: Cesarean section is one of the most commonly performed surgical procedures in obstetrics worldwide. Over  the last three decades, a tremendous increase in cesarean section rates has been observed globally, which is a cause for concern as procedure is associated with higher morbidity and mortality compared to vaginal delivery. This study was done to analyze the rate and indications for cesarean section and associated maternal morbidity and mortality.Methods: This retrospective study was conducted over a period of 6 months from 1st October 2017 to 31st March 2018 in the department of Obstetrics and Gynecology, Integral Institute of Medical Sciences and Research, Lucknow, India. Data of patients who were admitted for delivery in department of Obstetrics and Gynecology in OPD or emergency were recorded. Statistical analysis of various parameters namely, the cesarean section rates, its indications, the patient’s morbidity and mortality was done.Results: The total numbers of women delivered over the study period were 577, out of which 210 patients underwent cesarean sections. The overall cesarean section rate in our study was 36.39%. Previous cesarean section was the leading indication of cesarean section (31.9%) followed by arrest of labor (18.1%), CPD (14.2%), and fetal distress (12.9%). Breech presentation (5.2%), failed induction of labor (4.8%), pregnancy induced hypertension (PIH) (3.8%), oligohydramnios (3.3%), obstructed labor (2.4%), APH (1.4%), multiple pregnancy and BOH accounted for 0.95% of cesarean sections. 9% patients had few complications mainly minor wound infection (2.4%) and postpartum hemorrhage (2%). There was no mortality during this period.Conclusions: Previous cesarean section has been found to be the main indication for cesarean section. So primary cesarean section should be reduced to decrease the overall cesarean rates. A comprehensive, evidence based approach needs to be introduced to monitor indication of all cesarean section.

scholarly journals Pregnancy complicated by previous cesarean section: a retrospective study

2018 ◽  
Vol 7 (11) ◽  
pp. 4470
Author(s):  
Poornima M.
Keyword(s):  
Retrospective Study ◽  
Cesarean Section ◽  
Medical Records ◽  
Neonatal Outcome ◽  
Perinatal Morbidity ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Exclusion Criteria ◽  
History Of ◽  
Previous Cesarean

Background: Previous Cesarean section (CS) is one of the important causes of CS in subsequent pregnancies. Moreover, repeated cesarean sections increase maternal as well as perinatal morbidity and mortality. We conducted this study to find out outcome of pregnancies in women who had a history of previous CS.Methods: This was a retrospective study of patients of previous caesarean section for either maternal or fetal indications. The duration of study was 3 years. Total 215 patients were included in this study on the basis of a predefined inclusion and exclusion criteria. The indications, maternal and neonatal outcome were studied from medical records of the patients. Statistical analysis was done using SSPE 22.0 software.Results: Out of 215 studied cases majority of the patients belonged to age group of 21-30 years (75.35%) and were 2nd gravida (61.86%). 164 (76.28%) patients attended ANC OPD at least for 3 times during pregnancy. 73 (33.95%) patients had Hb of less than 10 gms while blood transfusion was required to be given in 11 (5.12%) patients. cesarean section was required in 172 (80%) patients out of which 166 (77.21%) patients had undergone emergency LSCS while in 6 (2.79%) patients elective LSCS was done. Scar tenderness was the most common indication for repeat cesarean section. There was no maternal mortality in any patients while there was 1 still birth and 1 neonatal death.Conclusions: Previous cesarean section is one of the important causes of CS in subsequent pregnancies hence decision of doing CS, especially primigravida, must be taken in accordance with strict guidelines and the practice of “cesarean section on demand” should be discouraged.

scholarly journals Analysis of Cesarean Sections using Robson’s Ten Group Classification System

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Rashida Parveen ◽  
Mehnaz Khakwani ◽  
Anum Naz ◽  
Rabia Bhatti
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Fetal Distress ◽  
Group Classification ◽  
Care Hospital ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Group 10 ◽  
Group 5 ◽  
Previous Cesarean

Objective: To analyze trends of CSs and evaluating them according to Robson’s Ten Groups Classification System (TGCS) at a leading government tertiary care hospital of South Punjab, Pakistan. Methods: This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Nishtar Medical University Hospital, Multan Pakistan, from October 2019 to March 2020.The study population included a total of 167 women who underwent CS in the hospital during the specified study period. For each case, we collected data regarding maternal characteristics and pregnancy-related information. The dependent variable was Robson classification group. Results: Overall, mean age was 26.53+5.1 years. Majority of the women, 116 (69.5%) belonged to urban areas of residence, 74 (44.3%) gestational aged between 37-42 years while 108 (64.7%) had history of cesarean section. Most of the patients, 85 (50.9%) turned out to be from TGCS Group-10. Group-5 and Group-1 were the 2nd and 3rd most common group, accounted for 24 (14.4%) and 19 (11.4%) cases respectively. Previous cesarean section (20.4%) and fetal distress (19.8%) were found to be most common indications leading to cesarean section. Conclusion: As per Robson’s Ten-Group Classification, Group-10 and Group-5 were found to be the most contributing among deliveries done. Previous cesarean section and fetal distress were the most common indications of cesarean section. doi: https://doi.org/10.12669/pjms.37.2.3823 How to cite this:Parveen R, Khakwani M, Naz A, Bhatti R. Analysis of Cesarean Sections using Robson’s Ten Group Classification System. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3823 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Gynecological outcomes of uterine niche after cesarean section: A descriptive study

2021 ◽  
Vol 2 ◽  
pp. 5
Author(s):  
E. A. Abdelfattah ◽  
T. M. Abd-El Dayem ◽  
H. M. Galal ◽  
S. S. Taylon
Keyword(s):  
Cesarean Section ◽  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Maternity Hospital ◽  
University Hospital ◽  
Cesarean Sections ◽  
Gynecological Examination ◽  
The Social ◽  
Space Data ◽  
Previous Cesarean

Objectives: Our aim was to study the prevalence of isthmocele in cases with previous cesarean section scar presented to El Shatby maternity university hospital and its association with gynecological complications. Material and Methods: After approval of the ethics committee of Alexandria faculty of medicine, a sample of 300 patients delivered by cesarean section since 6 months or more presented by one or more of the following symptoms: Abnormal uterine bleeding (AUB) dysmenorrhea, secondary infertility, and lower abdominal pain were selected from the gynecology clinic of El Shatby maternity university hospital. All patients were subjected to history taking, clinical, and gynecological examination. Post-menstrual 2D transvaginal ultrasonography was done. Where the niche or isthmocele was seen as triangular or dome- shaped echo-free space. Data were collected and entered to the computer using Statistical Package for the Social Science program for statistical analysis. Results: Niche was found in 44 cases. Most of them were symptomatic. Duration from the last (CS) was statistically significant. Symptoms were related to number of previous cesarean sections. Conclusion: The incidence of post-cesarean section niche in El Shatby Maternity hospital was 14.67%. Most common symptoms were AUB and dyspareunia.

scholarly journals Risk of severe acute maternal morbidity according to gestational age at delivery in twin pregnancies

2022 ◽  
Vol 226 (1) ◽  
pp. S595-S596
Author(s):  
Lola Loussert ◽  
Catherine Deneux-Tharaux ◽  
Aurélien Seco ◽  
François Goffinet ◽  
Diane Korb ◽  
...  
Keyword(s):  
Gestational Age ◽  
Maternal Morbidity ◽  
Severe Acute Maternal Morbidity ◽  
Gestational Age At Delivery ◽  
Twin Pregnancies
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