scholarly journals Outcome of Pregnancy with History of Previous Cesarean Section

2017 ◽  
Vol 9 (4) ◽  
pp. 308-311
Author(s):  
Reena J DSouza ◽  
Bandeppa H Narayani ◽  
Smitha B Rao
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Perinatal Death ◽  
Placenta Previa ◽  
Birth Asphyxia ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
History Of ◽  
Previous Cesarean

ABSTRACT In modern obstetric practice, pregnancy with history of previous cesarean section is quite common. A cesarean section poses some documented risks to the mother's health in subsequent pregnancies like placenta previa or accreta and uterine scar rupture. It is also associated with increased likelihood of preterm delivery, low birth weight, and perinatal death. Repeat cesarean section is technically difficult and there is chance of injury to surrounding structures. The retrospective study was done in Yenepoya Medical College Hospital during the period of January 2014 to January 2015 to find out the maternal antepartum and intrapartum complications as well as perinatal outcome in patients with a history of cesarean section. A total number of 143 pregnant patients with history of one or more cesarean section who underwent repeat cesarean sections were included. Previous classical cesarean, extreme prematurity, and those who opted for vaginal birth after cesarean (VBAC) were excluded. Mean age of the study population was 27.4 years. Here, 72.12 and 20.98% cases had history of previous one and two cesarean sections respectively. Important antepartum complications were placenta previa (3.50%), scar tenderness (8.39%), gestational diabetes mellitus (GDM; 4.90%), pregnancy-induced hypertension (PIH; 6.99%), etc. There were extensive peritoneal and bladder adhesions in 13.99 and 16.78% cases respectively, causing much preoperative difficulties and in one case urinary bladder was injured during operation. Postoperative period was uneventful in 72.72% cases. In this study, 20.28% neonates developed some complications like prematurity, low birth weight, birth asphyxia, and neonatal jaundice. Here the rate of perinatal mortality was 1.4%. How to cite this article DSouza RJ, Narayani BH, Rao SB. Outcome of Pregnancy with History of Previous Cesarean Section. J South Asian Feder Obst Gynae 2017;9(4):308-311.

scholarly journals Pregnancy complicated by previous cesarean section: a retrospective study

2018 ◽  
Vol 7 (11) ◽  
pp. 4470
Author(s):  
Poornima M.
Keyword(s):  
Retrospective Study ◽  
Cesarean Section ◽  
Medical Records ◽  
Neonatal Outcome ◽  
Perinatal Morbidity ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Exclusion Criteria ◽  
History Of ◽  
Previous Cesarean

Background: Previous Cesarean section (CS) is one of the important causes of CS in subsequent pregnancies. Moreover, repeated cesarean sections increase maternal as well as perinatal morbidity and mortality. We conducted this study to find out outcome of pregnancies in women who had a history of previous CS.Methods: This was a retrospective study of patients of previous caesarean section for either maternal or fetal indications. The duration of study was 3 years. Total 215 patients were included in this study on the basis of a predefined inclusion and exclusion criteria. The indications, maternal and neonatal outcome were studied from medical records of the patients. Statistical analysis was done using SSPE 22.0 software.Results: Out of 215 studied cases majority of the patients belonged to age group of 21-30 years (75.35%) and were 2nd gravida (61.86%). 164 (76.28%) patients attended ANC OPD at least for 3 times during pregnancy. 73 (33.95%) patients had Hb of less than 10 gms while blood transfusion was required to be given in 11 (5.12%) patients. cesarean section was required in 172 (80%) patients out of which 166 (77.21%) patients had undergone emergency LSCS while in 6 (2.79%) patients elective LSCS was done. Scar tenderness was the most common indication for repeat cesarean section. There was no maternal mortality in any patients while there was 1 still birth and 1 neonatal death.Conclusions: Previous cesarean section is one of the important causes of CS in subsequent pregnancies hence decision of doing CS, especially primigravida, must be taken in accordance with strict guidelines and the practice of “cesarean section on demand” should be discouraged.

scholarly journals A Planned Cesarean Section-Hysterectomy For Placenta Previa Totalis Percreta In Patient With History Of Two Cesarean Sections

Medicinus ◽  
2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Julita Nainggolan
Keyword(s):  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Health Resources ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cesarean Sections ◽  
History Of ◽  
Rising Incidence ◽  
Previous Cesarean

<p><em>The presence of placenta previa may be associated with placenta accreta</em><em><sup>[1]</sup></em><em>.<sup>  </sup></em><em>Maternal and fetal morbidity and mortality from placenta previa accreta are considerable and are associated with high demands on health resources. With the rising incidence of caesarean sections combined with increasing maternal age, the number of cases of placenta praevia and its complications, including placenta accreta, will continue to increase</em><em><sup>[2]</sup></em><em>. </em><em>Here, we present a case of  placenta previa totalis percreta in previous cesarean section twice. In this case, patient with placenta previa totalis-percreta we diagnosed and prepared  proper management with the involvement of multidisciplinary team. We reduced blood loss by performing total abdominal hysterectomy immediately after delivered the baby and the postoperative course was uneventful.</em></p><p><strong><em>Keywords: Cesarean Section-Hysterectomy, placenta accreta, placenta percreta, placenta previa</em></strong></p>

scholarly journals Evaluation of Uterine Scar on Repeat Second Cesarean Section in Patients with Previous Cesarean Section

1970 ◽  
Vol 3 (1) ◽  
pp. 16-19
Author(s):  
N Nargis ◽  
AK Al-Mahmood ◽  
D Akhter
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
History Of ◽  
Uterine Scar ◽  
One Year ◽  
Operative Findings ◽  
A Prospective Study ◽  
Previous Cesarean

To evaluate the safety and integrity of uterine scar at repeat cesarean section in patients with previous one cesarean section (C/S). A prospective study was Carried out in a tertiary care, obstetric unit over a period of one year, 2010. All pregnant mothers who underwent cesarean section either emergency or elective with history of previous one cesarean sections were included in this study. The variables noted were age, parity, socioeconomic status, residential area, location of previous cesarean section, previous wound infection and associated complaints. Data was analyzed on SPSS 11 Operative findings during cesarean sections were recorded in terms of thinning of scar, dehiscence or rupture. One hundred and twenty cesarean section patients were included in the study. Out of all patients, extreme thinning of scar was noted in 28 (23.33%) patients. Four patients (3.33%) had scar dehiscence,only 3( 2.5%) patients with scar dehiscence had associated complaint of scar tenderness, while 17 (14.16%) of 120 cases of scar thinning were having scar tenderness. All 4 cases of scar dehiscence had their previous c/s at peripheral hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Our findings shows relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it seems to be a safe approach to make trial of labour after meticulous scrutinization and individualization. DOI: http://dx.doi.org/10.3329/akmmcj.v3i1.10108 AKMMCJ 2012; 3(1): 16-19

scholarly journals Placental complications after a previous cesarean section

2009 ◽  
Vol 62 (5-6) ◽  
pp. 212-216 ◽  
Author(s):  
Jelena Milosevic ◽  
Vekoslav Lilic ◽  
Marija Tasic ◽  
Dragana Radovic-Janosevic ◽  
Milan Stefanovic ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Placental Abruption ◽  
Placenta Previa ◽  
Statistical Significance ◽  
Control Group ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Gynecology And Obstetrics ◽  
Prior Cesarean Section ◽  
Previous Cesarean

Introduction The incidence of cesarean section has been rising in the past 50 years. With the increased number of cesarean sections, the number of pregnancies with the previous cesarean section rises as well. The aim of this study was to establish the influence of the previous cesarean section on the development of placental complications: placenta previa, placental abruption and placenta accreta, as well as to determine the influence of the number of previous cesarean sections on the complication development. Material and methods The research was conducted at the Clinic of Gynecology and Obstetrics in Nis covering 10-year-period (from 1995. to 2005.) with 32358 deliveries, 1280 deliveries after a previous cesarean section, 131 cases of placenta previa and 118 cases of placental abruption. The experimental groups was presented by the cases of placenta previa or placental abruption with prior cesarean section in obstetrics history, opposite to the control group having the same conditions but without a cesarean section in medical history. RESULTS The incidence of placenta previa in the control group was 0.33%, opposite to the 1.86% incidence after one cesarean section (p<0.001), 5.49% after two cesarean sections and as high as 14.28% after three cesarean sections in obstetric history. Placental abruption was recorded as placental complication in 0.33% pregnancies in the control group, while its incidence was 1.02% after one cesarean section (p<0.001) and 2.02% in the group with two previous cesarean sections. The difference in the incidence of intrapartal hysterectomy between the group with prior cesarean section (0.86%) and without it (0.006%) shows a high statistical significance (p<0.001). CONCLUSION The previous cesarean section is an important risk factor for the development of placental complications.

scholarly journals Prevalence and risk factors of severe postpartum hemorrhage: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chen-ning Liu ◽  
Fu-bing Yu ◽  
Yun-zhe Xu ◽  
Jin-sheng Li ◽  
Zhi-hong Guan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Maternal Age ◽  
Placenta Previa ◽  
Previous Cesarean Section ◽  
Estimated Blood Loss ◽  
History Of ◽  
Prolonged Labor ◽  
Previous Cesarean

Abstract Background Although maternal deaths are rare in developed regions, the morbidity associated with severe postpartum hemorrhage (SPPH) remains a major problem. To determine the prevalence and risk factors of SPPH, we analyzed data of women who gave birth in Guangzhou Medical Centre for Critical Pregnant Women, which received a large quantity of critically ill obstetric patients who were transferred from other hospitals in Southern China. Methods In this study, we conducted a retrospective case-control study to determine the prevalence and risk factors for SPPH among a cohort of women who gave birth after 28 weeks of gestation between January 2015 and August 2019. SPPH was defined as an estimated blood loss ≥1000 mL and total blood transfusion≥4 units. Logistic regression analysis was used to identify independent risk factors for SPPH. Results SPPH was observed in 532 mothers (1.56%) among the total population of 34,178 mothers. Placenta-related problems (55.83%) were the major identified causes of SPPH, while uterine atony without associated retention of placental tissues accounted for 38.91%. The risk factors for SPPH were maternal age < 18 years (adjusted OR [aOR] = 11.52, 95% CI: 1.51–87.62), previous cesarean section (aOR = 2.57, 95% CI: 1.90–3.47), history of postpartum hemorrhage (aOR = 4.94, 95% CI: 2.63–9.29), conception through in vitro fertilization (aOR = 1.78, 95% CI: 1.31–2.43), pre-delivery anemia (aOR = 2.37, 95% CI: 1.88–3.00), stillbirth (aOR = 2.61, 95% CI: 1.02–6.69), prolonged labor (aOR = 5.24, 95% CI: 3.10–8.86), placenta previa (aOR = 9.75, 95% CI: 7.45–12.75), placenta abruption (aOR = 3.85, 95% CI: 1.91–7.76), placenta accrete spectrum (aOR = 8.00, 95% CI: 6.20–10.33), and macrosomia (aOR = 2.30, 95% CI: 1.38–3.83). Conclusion Maternal age < 18 years, previous cesarean section, history of PPH, conception through IVF, pre-delivery anemia, stillbirth, prolonged labor, placenta previa, placental abruption, PAS, and macrosomia were risk factors for SPPH. Extra vigilance during the antenatal and peripartum periods is needed to identify women who have risk factors and enable early intervention to prevent SPPH.

scholarly journals A Planned Cesarean Section-Hysterectomy for Placenta Previa Totalis Percreta in Patient with History of Two Cesarean Sections

Medicinus ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 13
Author(s):  
Julita Nainggolan
Keyword(s):  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Health Resources ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cesarean Sections ◽  
History Of ◽  
Rising Incidence ◽  
Previous Cesarean

<p class="Default">The presence of placenta previa may be associated with placenta accreta<sup>[1]</sup>.<sup>  </sup>Maternal and fetal morbidity and mortality from placenta previa accreta are considerable and are associated with high demands on health resources. With the rising incidence of caesarean sections combined with increasing maternal age, the number of cases of placenta praevia and its complications, including placenta accreta, will continue to increase<sup>[2]</sup>. Here, we present a case of  placenta previa totalis percreta in previous cesarean section twice. In this case, patient with placenta previa totalis-percreta we diagnosed and prepared  proper management with the involvement of multidisciplinary team. We reduced blood loss by performing total abdominal hysterectomy immediately after delivered the baby and the postoperative course was uneventful.<strong></strong></p>

scholarly journals Risk Factors and Pregnancy Outcome in Women With a History of Cesarean Section Complicated by Placenta Accreta

2020 ◽  
Author(s):  
Yingyu Liang ◽  
lizi Zhang ◽  
Shilei Bi ◽  
Jingsi Chen ◽  
Shanshan Zeng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Cesarean Sections ◽  
Han Ethnicity ◽  
Parity Number ◽  
History Of ◽  
Independent Risk Factors ◽  
Previous Cesarean

Abstract Objective: To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta.Methods: This retrospective study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in 7 provinces of China between January 2017 and December 2017. According to the intraoperative findings or the pathologic diagnosis after delivery, the study population was divided into placenta accreta (PA) and non-PA groups. We compared the pregnancy outcomes between the 2 groups, used multivariate logistic regression to analyze the risk factors for placental accreta, and used receiver operating characteristic curves to evaluate the value of the risk factors.Results: For this study we included 11,074 pregnant women with a history of cesarean section; and of these, 869 cases were in the PA group and 10,205 cases were in the non-PA group. Compared with the non-PA group, the probability of postpartum hemorrhage, severe postpartum hemorrhage, diffuse intravascular coagulation, puerperal infection, intraoperative bladder injury, hysterectomy, and blood transfusion was significantly increased in the placenta accreta group (P<0.05)). At the same time, the rate of neonatal low-birth weight, the probability of neonatal comorbidities, and the rate of neonatal intensive care unit admission also increased significantly (P<0.05). Weight, parity, number of miscarriages, number of previous cesarean sections, history of premature rupture of membrane, previous cesarean-section transverse incisions, history of placenta previa, and the combination of prenatal hemorrhage and placenta previa were all independent risk factors for placenta accreta; while non-Han ethnicity was an independent protective factor for placenta accreta (P<0.05). The area under the ROC curve (AUC) was 0.93 (95% CI=0.92-0.94); and the specificity, sensitivity, and accuracy rate were 0.87, 0.93, and 0.93, respectively.Conclusions: There was an increased risk of adverse outcomes in pregnancies complicated by placenta accreta in women with a history of cesarean section, and this required close clinical attention. Weight before pregnancy, parity, number of miscarriages, number of previous cesarean sections, Han ethnicity, history of premature rupture of membranes, past transverse incisions in cesarean sections, a history of placenta previa, prenatal hemorrhage, and placenta previa were independent risk factors for pregnancies complicated with placenta accreta in women with a history of cesarean section. These independent risk factors showed a high value in predicting the risk for placental accreta in pregnancies of women with a history of cesarean section.

scholarly journals Analysis of Cesarean Sections using Robson’s Ten Group Classification System

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Rashida Parveen ◽  
Mehnaz Khakwani ◽  
Anum Naz ◽  
Rabia Bhatti
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Fetal Distress ◽  
Group Classification ◽  
Care Hospital ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Group 10 ◽  
Group 5 ◽  
Previous Cesarean

Objective: To analyze trends of CSs and evaluating them according to Robson’s Ten Groups Classification System (TGCS) at a leading government tertiary care hospital of South Punjab, Pakistan. Methods: This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Nishtar Medical University Hospital, Multan Pakistan, from October 2019 to March 2020.The study population included a total of 167 women who underwent CS in the hospital during the specified study period. For each case, we collected data regarding maternal characteristics and pregnancy-related information. The dependent variable was Robson classification group. Results: Overall, mean age was 26.53+5.1 years. Majority of the women, 116 (69.5%) belonged to urban areas of residence, 74 (44.3%) gestational aged between 37-42 years while 108 (64.7%) had history of cesarean section. Most of the patients, 85 (50.9%) turned out to be from TGCS Group-10. Group-5 and Group-1 were the 2nd and 3rd most common group, accounted for 24 (14.4%) and 19 (11.4%) cases respectively. Previous cesarean section (20.4%) and fetal distress (19.8%) were found to be most common indications leading to cesarean section. Conclusion: As per Robson’s Ten-Group Classification, Group-10 and Group-5 were found to be the most contributing among deliveries done. Previous cesarean section and fetal distress were the most common indications of cesarean section. doi: https://doi.org/10.12669/pjms.37.2.3823 How to cite this:Parveen R, Khakwani M, Naz A, Bhatti R. Analysis of Cesarean Sections using Robson’s Ten Group Classification System. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3823 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Safety of Scar on Repeat Second Cesarean Section in Patients with Previous One Cesarean Section

2009 ◽  
Vol 1 (2) ◽  
pp. 26-28
Author(s):  
Shahnaz Kouser ◽  
Shaheen Kouser ◽  
Bushra Anwar
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Teaching Hospitals ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Medical Disorders ◽  
Elective Cesarean ◽  
One Year ◽  
Operative Findings ◽  
Previous Cesarean

ABSTRACT Objective To evaluate the safety and integrity of scar at repeat cesarean section, in patients with previous one cesarean section performed at different settings. Study design A reterospective study in a tertiary care obstetric unit over a period of one year (2006). Material and methods All patients with previous one cesarean section, undergoing emergency and elective cesarean sections were enrolled at our institution. The variables noted were age, parity, residential area, location of previous cesarean section and associated complaints, e.g uterine contractions, vaginal leaking/ bleeding and comorbid medical disorders. Outcome measures Operative findings in terms of thinning of scar, dehiscence or rupture were recorded. The effects of skill level of surgeon and set-up of previous cesarean section were analyzed. Results Two hundred and seventy cesarean sections were performed for different indications in patients with previous one cesarean section over a period of one year. Out of all patients, extreme thinning of scar was noted in 36 (13.3%) patients. Seven patients(2.6%) had scar dehiscence. Only 3 (42.8%) patients with scar dehiscence had associated complaint of scar tenderness, while 22 (61%)of 36 cases of scar thinning were having scar tenderness. All 7 cases of scar dehiscence had their previous cesarean sections at teaching hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Conclusion The study concludes relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it will still be safe to subject the patients to trial of labor after meticulous scrutinization and individualization. At the same time adequate surgical training of doctors (trainees and community doctors) through different formats is recommended.

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