Delivery by repeat caesarean section today: an overview

Authors

  • D. M. Christe National Institute for Research in Human Reproduction, Field Unit, Indian Council of Medical Research, India Institute of Obstetrics and Gynecology and Government Hospital for Women and Children, Chennai, Tamil Nadu, India
  • Shaanthy T. K. Gunasingh Institute of Obstetrics and Gynecology and Government Hospital for Women and Children, Chennai, Tamil Nadu, India Department of Obstetrics and Gynecology, Madras Medical College, Chennai, Tamil Nadu, India
  • V. Bharani Institute of Obstetrics and Gynecology and Government Hospital for Women and Children, Chennai, Tamil Nadu, India Department of Obstetrics and Gynecology, Madras Medical College, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20184140

Keywords:

Neonatal outcome, Obstetric complications, Repeat caesarean section

Abstract

Background: To find out the maternal and neonatal outcome and background characteristics of women delivering by repeat caesarean section in a tertiary care centre in Chennai, South India.

Methods: Parturition records for the year 2017, were accessed and case records, for the calculated sample size were selected. Demographic features, obstetric history, gestational age and antenatal complications were recorded. Maternal outcome and baby details including sex of the baby, birth weight, APGAR and admission to New born Intensive Care Unit (NICU) data and acceptance of postpartum contraception was noted.

Results: In the study group, 156 women delivered by repeat caesarean section.  The age group of women ranged from 20 years to 38 years.  Majority of 83.4% of women were Para one.  Threatening rupture was recorded in 2.6% of women. The risk of previous two CS scars was noted in 3.2% of women. More than 41% of women had other complications. Most often observed complications were Gestational hypertension, Gestational diabetes, preeclampsia and eclampsia. Pregnancy complications of oligohydramnios, twins, breech and abnormal presentation, were significant. 1% of women had associated medical complications of anaemia and hypothyroidism.  Maternal and Fetal causes were the most important indication for caesarean section in 74% of women. There were no maternal deaths in present study group. Postpartum contraception was accepted by 55 % of women.

Conclusions: Majority of repeat caesarean section was observed most commonly in para one women in the age group of 26-30 years More than 41% of women had associated medical and obstetric complications. There were no maternal deaths in this study. Neonatal deaths were 2.5%.

References

Melamed N, Hadar E, Keidar L, Peled Y, Timing of planned repeat cesarean delivery after two or more previous cesarean sections--risk for unplanned cesarean delivery and pregnancy outcome. J Matern Fetal Neonatal Med. 2014;27(5):431-8.

Black M, Bhattacharya S, Philip S, Norman JE, McLernon DJ., Planned Repeat Cesarean Section at Term and Adverse Childhood Health Outcomes: A Record-Linkage study. PLoS Med. 2016;13(3): e1001973.

Mascarello KC, Matijasevich A, Barros AJ, Santos IS, Zandonade E, Silveira MF., Repeat cesarean section in subsequent gestation of women from a birth cohort in Brazil. Reproductive Health 2017: 14(1):102.

Balachandran L, Vaswani PR, Mogotlane R. Pregnancy outcome in women with previous one cesarean section. Journal of clinical and diagnostic research: JCDR. 2014;8(2):99.

RCOG. Green-top Guideline Number 45 Birth After Previous Caesarean Birth. October 2015

Gagliardi L. Pregnancy complications and neonatal outcomes: problems and perspectives. Acta Paediatrica. 2014;103(7):682-3.

M. Kaplanoglu, A. Karateke, Burak Un, et al. Complications and outcomes of repeat cesarean section in adolescent women. Int J Clin Exp Med. 2014;7(12):5621-8.

Nandini Naskar, Arakhita Swain, Kedar Nath Das and Abhaya Kumar Patnayak. Maternal Risk Factors, Complications and Outcome of Very Low Birth Weight Babies: Prospective Cohort Study from a Tertiary Care Centre in Odisha, J Neonat Biol. 2014;3(3):142.

Malak M. Al-Hakeem. Pregnancy Outcome of Gestational Diabetic Mothers: Experience in A Tertiary Center. J Family Community Med. 2006;13(2):55-9

Anggondowati T, El-Mohandes AA, Qomariyah SN, Kiely M, Ryon JJ, Gipson RF et al, Maternal characteristics and obstetrical complications impact neonatal outcomes in Indonesia: a prospective study, BMC Pregnancy Childbirth. 2017;17(1):100.

Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, Bommarito K, Madden T, Olsen MA, Subramaniam H, Peipert JF, Bierut LJ. Maternal age and risk of labor and delivery complications. Maternal Child Health J. 2015;19(6):1202-11.

Blomberg M, Tyrberg RB, Kjølhede P. Impact of maternal age on obstetric and neonatal outcome with emphasis on primiparous adolescents and older women: a Swedish Medical Birth Register Study. BMJ open. 2014;4(11):e005840.

Pacagnella RC, Cecatti JG, Parpinelli MA, Sousa MH, Haddad SM, Costa ML, Souza JP, Pattinson RC. Delays in receiving obstetric care and poor maternal outcomes: results from a national multicentre cross-sectional study. BMC Pregnancy Childbirth. 2014;14(1):159.

Konar H, Sarkar M, Paul J. Perinatal Outcome of the Second Twin at a Tertiary Care Center in India. The J Obstet Gynecol India. 2016;66(6):441-7.

Chiwanga ES, Massenga G, Mlay P, Obure J, Mahande MJ. Maternal outcome in multiple versus singleton pregnancies in Northern Tanzania: a registry-based case control study. Asian Pacific J Reprod. 2014;3(1):46-52.

Goldstuck ND, Steyn PS. Insertion of intrauterine devices after cesarean section: a systematic review update. International journal of women's health. 2017;9:205.

Melamed N, Segev M, Hadar E, Outcome of trial of labor after cesarean section in women with past failed operative vaginal delivery, Am J Obstet Gynecol. 2013;209(1):49.e1-7.

Blanc-Petitjean P, Salomé M, Dupont C, Labour induction practices in France: A population-based declarative survey in 94 maternity units, J Gynecol Obstet Hum Reprod. 2018 ;47(2):57-62.

Magne F, Puchi Silva A, Carvajal B, The Elevated Rate of Cesarean Section and Its Contribution to Non-Communicable Chronic Diseases in Latin America: The Growing Involvement of the Microbiota, Front Pediatr. 2017;5:192.

Montoya-Williams D, Lemas DJ, Spiryda L. What Are Optimal Cesarean Section Rates in the U.S. and How Do We Get There? A Review of Evidence-Based Recommendations and Interventions, J Womens Health (Larchmt). 2017;26(12):1285-91.

Downloads

Published

2018-09-26

Issue

Section

Original Research Articles