The maternal and fetal outcome of repeat previous one  caesarean section

Uma Jain; Deepali Jain; Shaily Sengar; Preeti Gupta

doi:10.18203/2320-1770.ijrcog20213168

Authors

Uma Jain Department of Obstetrics and Gynacology, GMC Associated with DHS, Shivpuri, Madhya Pradesh, India
Deepali Jain GMC, Shivpuri, Madhya Pradesh, India
Shaily Sengar Department of Obstetrics and Gynaecology, GMC, Shivpuri, Madhya Pradesh, India
Preeti Gupta Gupta Hospital, Morar, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20213168

Keywords:

Caesarean section, Maternal morbidity, Neonatal morbidity, VBAC

Abstract

Background: The rates of adverse maternal and neonatal outcomes have increased significantly in the last decade. Patients with repeated caesarean deliveries also have a greater risk of placenta previa, placenta accrete, uterine rupture, bowel and bladder injury, and unplanned hysterectomy.

Methods: This retrospective study was performed between 01 April 2017 to 31 March 2021, at a private hospital to know about the surgical difficulties and maternal and neonatal complications encountered in cases of repeated LSCS. The outcome of 1028 women admitted with a history of previous LSCS was studied.

Results: The 613 patients were given a trial of labour. 40.07% of patients delivered normally. The most common indication for repeat LSCS was CPD in 20.94% and fetal distress 20.12%. The most common complication observed was adhesion in 37.65%. Scar dehiscence in 8.92 %, scar rupture in 0.64%, uterine atony in 4.8%, placenta previa in 3.57%, placenta accrete in 0.64%, injury to the bladder was seen in 0.97%, caesarean hysterectomy was done in only 2 cases and gaped wound was found in 1.13% of cases. 19.15% of neonates were admitted to NICU. Apgar score <7 at 5 minutes in 14.77%. premature neonates were 8.44% RDS was found in 7.62%, birth asphyxia was found in 2.92% cases and neonatal sepsis was found in 1.13%.

Conclusions: The dramatic increase in caesarean section rates over the past three decades has been associated with a corresponding increase in maternal morbidity but there a continuous decrease in neonatal morbidity and mortality rates because of advances in neonatal medicine.

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Author Biographies

Uma Jain, Department of Obstetrics and Gynacology, GMC Associated with DHS, Shivpuri, Madhya Pradesh, India

Obstetric & Gynecology

Designated Professor, GMC Shivpuri.

Deepali Jain, GMC, Shivpuri, Madhya Pradesh, India

Senior Resident, Department of Obstetrics & Gynaecology, GMC Shivpuri M.P. India.

Preeti Gupta, Gupta Hospital, Morar, Madhya Pradesh, India

Department of Obstetrics and Gynaecology, Gupta Maternity hospital and infertility centre, Morar, Madhya Pradesh,

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