The prevalence of maternal and newborn morbidity following a repeat cesarean section: Data from Zagazig University Hospital

Cesarean section (CS) is one of the most common obstetric procedures performed worldwide, and new research indicates that the frequency of CS is increasing. Maternal-fetal morbidity and death due to CS is a serious public health problem worldwide. Our study aimed to assess the impact of multiple cesarean sections (CSs) on mother-fetal morbidity. This cross-sectional study was performed on 165 women who underwent multiple repeated CSs in our clinic and met the criteria of inclusion by evaluating their records. All women were divided into 3 groups according to the number of CSs: 2nd (n = 111), 3rd (n = 44), and 4th/5th (n = 10). Maternal-neonatal outcomes; blood transfusion needs, adhesions, APGAR scores, and respiratory difficulties were investigated retrospectively. Our results revealed that adhesion (60.6 %) was the most frequent maternal complication. The prevalence of thick adhesions decreased with the number of cesarean sections performed (70, 25, and 5 cases for the previous 2nd, 3rd, and 4 or more CS, respectively). There was no statistically significant difference between the groups in terms of adhesions, uterine rupture, bladder injury, endometritis, and wound infection. NICU admission (14.5 %), Low birth weight (3.6 %), and IUGR (3.03 %) were among the unfavorable fetal outcomes. There was a significant difference among the three studied groups regarding APGAR score, maternal age, and hospital stay, while a non-significance was found in birth weight and maternal adhesion. Our findings support our hypothesis that the likelihood of maternal complications rises as the number of CSs rises. The manner and time of delivery have a greater impact on infant outcome than the number of CSs. There is no clear absolute barrier for the number of CSs, however, 4 or more cesarean births were recognized as the essential level for the majority of outcomes. The number of CSs must be decreased to reduce the associated issues.