Case series of multiple repeat caesarean sections: Operative, maternal, and neonatal outcome
Journal of Maternal-Fetal and Neonatal Medicine, Volume 29, No. 12, Year 2016
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Objective: The objective of this study is to review the maternal and neonatal morbidity and mortality associated with six or more caesarean section (CS). Methods: We conducted a retrospective chart review, at King Abdulaziz University Hospital (KAUH) in Jeddah, for all patients admitted between 2000 through 2010 and identified five patients having more than six CS deliveries. Results: Deliveries occurred in the ranges of 31-38 weeks, from which four cases required emergency CS. There were two cases in the series with a placenta previa. There was a single case of uterine dehiscence. Only one case required a blood transfusion and was complicated with a placenta accreta, bladder injury, urinary tract infection, and prolonged maternal hospital stay with neonatal intensive care unit (NICU) admission. All cases had moderate to severe adhesion intra-operatively. Operative time was long in all cases with a range 55-106 min. One of the five cases had a postoperative wound infection. Finally, none of the current series showed fetal or maternal mortalities. Conclusions: The long-term complications associated with CS should be discussed with patients in the first and subsequent pregnancies. This case series highlighted the outcomes in these unique cases of higher order caesareans.