More Than Five Caesarean-Sections: Maternal and Perinatal Outcomes and Associated Risk Factors
Maryam Shoaib, Farida Kakar, Samia Saifullah, Sakina Naeem, Rizwana Naz
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ABSTRACT
Aim: To examine the maternal and neonatal outcomes in patients who received
more than five cesarean sections and associated risk factors.
Study
Design: Case control
Place and
Duration of Study: Gynecology and Obstetrics Department,
Sandeman Provincial Hospital Quetta from 1st January 2019 to 31st
December 2019.
Materials
and Methods: The number of patients was 100 patients with
age ranging between 20-50 years and gestation age >32 weeks. Demographic
details including patient’s age, residence, education and socioeconomic status
were recorded after written consent. The patients were divided into two groups;
Group A (n=50) consisted patients who had undergone five or more C-section
deliveries. Group B (n=50) consisted of patients who had less than five
C-sections. Intra and post-operative complications were recorded. Neonatal
outcomes such as admission to NICU, birth weight, Apgar score and mortality data
were recorded and results were compared.
Results:
In Group A, the incidence of extensive
adhesion was high 21 (42%) patients as compared to Group B (10%). Bowel injury
found in 3 (6%) patients in Group A while no patient in Group B. Placenta
previa found in 6 (12%) in Group A and 1 (2%) patients in Group B. Need of
blood transfusion rate was high in Group A, 24% as compared to Group B 8%. In
Group A 30% neonates required NICU admission. Low birth weight was higher in
Group A patients. 2% neonatal death was recorded in Group A while none in Group
B.
Conclusion:
Patients with five or more C-sections had higher risk of maternal and
neonatal morbidity. Patients should be aware about the adverse outcomes of
repeated C-section deliveries.
Keywords: C-sections, Maternal outcomes, Neonatal, Morbidity, Mortality