Fetomaternal Outcomes of Pregnancy with Multiple Repeat Caesarean Sections in a Tertiary Hospital in North-East India
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 5
Abstract
Introduction: Caesarean section is one of the most commonly performed surgical procedures all over the world associated with high maternal and fetal morbidity and even mortality. Aims and objects: To determine the fetomaternal outcomes in pregnancy with previous two or more caesarean sections. Materials and methods: We performed an observational clinical study over 9 months on patients with previous two or more caesarean sections. Maternal complications and fetal outcomes were evaluated. Results: Total 102 (1.48%) had previous two or more caesarean sections out of which only 1 patient had previous three caesarean sections. 92.2% cases were booked at RIMS antenatal clinic with three or more antenatal visits and 7.8% cases were unbooked. 68.6% patients underwent elective caesarean section while 31.4% patients underwent emergency caesarean section. Placenta previa was encountered in 7.8% patients of which 2% had morbid adhesion. The most common intraoperative complication was the presence of adhesions (23.5% cases) followed by haemorrhage(10.8%), thin LUS(2.9%), bladder injury(1.0%), scar dehiscence (1.0%). BT was needed in 14.7% cases, peripartum hysterectomy was done in 3.9% patients. There was no case of maternal mortality. 8 babies were born with low birth weight(<2.5 kg), 4(3.9%) babies had APGAR score <7 at 5th minute of birth and were subsequently admitted in NICU and were subsequently discharged. There was no stillbirth or neonatal mortality. Intraoperative complications and interventions were found to be significantly higher in the unbooked patients than in the booked ones and also in the patients with emergency CS than in those with elective CS. Conclusion: Fetomaternal complications are increased in multiple repeat caesarean sections. Risk reduction may be possible by managing in tertiary centres, following strict indications in first CS, regular antenatal checkups and prior anticipation and preparedness for complications.
Authors and Affiliations
Puja Banik, R K Praneshwari Devi, Ahanthembi Sanaton, Alpana Thounaojam, Visenuo Ethel Solo, Pawan Kumar, Ending Jamoh, Cherry Wann
Keywords
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- EP ID EP373945
- DOI 10.9790/0853-1705021925.
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