DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20184491

Pregnancy complicated by previous cesarean section: a retrospective study

Poornima M.

Abstract


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.


Keywords


Maternal and perinatal morbidity, Previous cesarean section, Outcome, Trial of labor

Full Text:

PDF

References


National Collaborating Centre for Women's and Children's Health (UK). Caesarean Section. London: RCOG Press; 2011 Nov. (NICE Clinical Guidelines, No. 132.) Available at: https://www.ncbi.nlm.nih.gov/books/NBK115309/

Armson BA. Is planned cesarean childbirth a safe alternative?. Canadian Med Associat J. 2007;176(4):475-6.

Barber El, Lundsberg L, Belanger K, Pettker Cm, Funai Ef, Illuzzi Jl. Contributing Indications to the Rising Cesarean Delivery Rate. Obstet Gynecol. 2011;118(1):29-38.

Rahman M, Ahmad Shariff A, Shafie A, Saaid R, Md Tahir R. Determinants of Caesarean Risk Factor in Northern Region of Bangladesh: A Multivariate Analysis. Iranian J Public Health. 2014;43(1):16-27.

Morrison J, MacKenzie IZ. Cesarean section on demand. Semin Perinatol. 2003;27(1):20-33.

Hemminki E. Impact of caesarean section on future pregnancy--a review of cohort studies. Paediatr Perinat Epidemiol. 1996;10(4):366-79.

Biswas A. Management of previous cesarean section. Curr Opin Obstet Gynecol. 2003;15(2):123-9.

Mesleh RA, Asiri F, Al-Naim MF. Cesarean section in the primigravid. Saudi Med J. 2000;21(10):957-9

Mascarello KC, Horta BL, Silveira MF. Maternal complications and cesarean section without indication: systematic review and meta-analysis. Revista de Saúde Pública. 2017;51:105.

Duperron L. Should patients be entitled to cesarean section on demand?: YES. Canadian Family Physician. 2011;57(11):1246-8.

Singh P, Hashmi G, Swain PK. High prevalence of cesarean section births in private sector health facilities- analysis of district level household survey-4 (DLHS-4) of India. BMC Public Health. 2018;18:613.

Neuman M, Alcock G, Azad K, Kuddus A, Osrin D, More NS, et al. Prevalence and determinants of caesarean section in private and public health facilities in underserved South Asian communities: cross-sectional analysis of data from Bangladesh, India and Nepal. BMJ Open. 2014;30;4(12):e005982.

Bangal VB, Giri PA, Shinde KK, Gavhane SP. Vaginal Birth after Cesarean Section. North Am J Med Sci. 2013;5(2):140-4.

Chua S, Arulkumaran S, Singh P, Ratnam SS. Trial of labour after previous caesarean section: obstetric outcome. Aust N Z J Obstet Gynaecol. 1989;29(1):12-7.

Mylonas I, Friese K. Indications for and Risks of Elective Cesarean Section. Deutsches Ärzteblatt Int. 2015;112(29-30):489-95.

Caughey AB, Shipp TD, Repke JT, Zelop C, Cohen A, Lieherman E. Trial of labor after cesarean delivery: the effect of previous vaginal delivery. Am J Obstet Gynecol. 1998;179(4):938-41.

McMahon MJ, Luther ER, Bowes WA Jr, Olshan AF. Comparison of a trial of labor with an elective second cesarean section. N Engl J Med. 1996;335(10):689-95.

Siwach S, Lakra P, Sangwan V, Shivani, Kansal R, Mahendru R. To study the outcome of previous one caesarean pregnancies in a rural tertiary center of Haryana, India. Int J Reprod Contracept Obstet Gynecol. 2017;6(11):5008-12.

Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The Increasing Trend in Caesarean Section Rates: Global, Regional and National Estimates: 1990-2014. Zeeb H, ed. PLoS ONE. 2016;11(2):e0148343.

Lydon-Rochelle MT, Gardella C, Cárdenas V, Easterling TR. Repeat cesarean delivery: what indications are recorded in the medical chart? Birth. 2006;33(1):4-11.