Maternal complications in repeated Caesarean section

Maternal complications in repeat cesarean section are increasing with the rising rate of cesarean section in the world. The aim of this study to evaluate intra-operative maternal complications of previous one and two cesarean section. It needs to the highlight for proper antenatal care and complication can be anticipated during surgery.Objective:To determine the frequency of intra-operative maternal complications among women undergoing repeated Caesarean section at Isra University hospital, Hyderabad.Material and methods:STUDY DESIGN: Cross-sectionalSETTING: The study was conducted obstetric and gynecology department of Isra University Hospital Hyderabad.DURATION OF STUDY: The study was of six months and the study process was carried out from 15th Agust 2011 to 15th February 2012.SAMPLE SIZE: 280 casesSAMPLE TECHNIQUE:Â Non probability, purposive samplingSAMPLE SELECTION:Inclusion criteria: All the pregnant women with history of previous one and previous to caesarean section availing obstetric and gynecology facilities at Isra University Hospital, Hyderabad Women regardless of any age group. Â Â Exclusion criteria:â€¢Â Â Â Â Â Â Â Â Â Pregnant women with no history of caesarean sectionâ€¢Â Â Â Â Â Â Â Â Â Pregnant women who refused to participate in the studyRESULTS:Â Â Â Â Â The mean + SD age was found to be 29.94 + 5.03 years; The maximum age of participants in this study was 45 years while the minimum age was 17 years. The age distribution of study participants was normally distributed. Regarding intra-operative complications, the prevalence of Adhesion is very high and alarming i.e. 97.5% among pregnant women undergoing repeated Caesarean section delivery. Â The prevalence of uterine scar dehiscence was not very high and it was confined to 17.9% in our study. The prevalence of difficult delivery of fetus a maternal complication was around 12% in our sample. The prevalence of excessive blood loss as an Intra-operative maternal complication was found to be 19% in our study. The prevalence of Caesarean Hysterectomy as an Intra-operative maternal complication was very minimum i.e.Â <2% in our sample. With regard to the association of age with intra-operative complication Adhesion among study participants, there was no difference in the mean age of two groups as evidenced by p-value of 0.103. Moreover, there was no association between age with intra-operative complication uterine scar dehiscence as evidenced by p-value of 0.837. Interestingly no association was observed between previous history of Caesarean section with intra-operative complication Adhesion among study participants. There was a significant association between previous history of Caesarean section and uterine scar dehiscence in our study.Conclusion: The present research makes a strong case that the prevalence of intra-operative complications among pregnant women undergoing repeated Caesarean section is not uncommon at Isra University hospital Hyderabad, Pakistan. This issue can have serious implications for maternal mortality and morbidity. Multiple cesarean deliveries are associated with one of the intra-operative complications â€œUterine scar dehiscenceâ€. The risk of major complications increases with cesarean delivery number.