Perioperative Complications of Repeat Cesarean section: An observational study at Mansoura University Hospital

Background: Cesarean section (CS) is a surgical technique of delivery that frequently saves the life of both the mother and the baby. It is known that multiple CS are associated with short and long-term risks for mothers and their babies. Aim: to detect different intra- and post- operative maternal and fetal complications of repeat CS operated at Mansoura University Hospital (MUH). Methods: This study was observational study and included 500 patients with history of one or more cesarean deliveries. All cases were subjected to full history taking, full examination, laboratory investigations and ultrasound work up. All pre-operative & intra-operative challenges and postoperative complications were recorded. Results: Regarding preoperative challenges, 206 cases required blood transfusion, premature rupture of membranes was reported in 33 cases and intrauterine fetal death occurred in 14 women. Poor Doppler findings were noted in 75 cases. Regarding intra-operative challenges, 81 women had signs of impending uterine rupture, while actual rupture occurred in 5 cases. Surgical difficulties were common, 115 cases had frozen pelvis, and 337 women had adhesions. Maternal post-operative complications were relatively common as fever, scar complications, and need for blood transfusion. Regarding fetal complications, Fetal anomalies were found in 26 cases and need for NICU was found in 170 cases. Conclusion: This study demonstrated high prevalence of maternal and fetal perioperative complications among women undergoing CS, particularly those with high parity, multiple previous CS, and with history of intrauterine fetal death. Emergent CS was significantly associated with increased complications compared to elective or urgent cases.