PT - JOURNAL ARTICLE AU - Hussein S. Qublan AU - Yousef Tahat TI - Multiple cesarean section. The impact on maternal and fetal outcome DP - 2006 Feb 01 TA - Saudi Medical Journal PG - 210--214 VI - 27 IP - 2 4099 - http://smj.org.sa/content/27/2/210.short 4100 - http://smj.org.sa/content/27/2/210.full SO - Saudi Med J2006 Feb 01; 27 AB - OBJECTIVE: To evaluate the complications, and to determine maternal and fetal risks in women who undergo 3 or more cesarean sections (CS), compared to those with one or 2 cesarean deliveries.METHODS: A retrospective analysis of 2276 CS performed between 1 January 2003 and 31 April 2005. We divided patients into 3 groups: Group 1 = with 1 previous CS (n=1183); Group 2 = 2 previous CS (n=781); and Group 3 = >3 previous CS (n=312).RESULTS: Compared to women with one or 2 cesarean deliveries, women who had >3 CS show significant increase in terms of prolonged operative time, uterine scar dehiscence, uterine rupture, placenta previa, placental adherence, and mild adhesion formation. We found no significant differences between the 3 study groups in terms of injury to surrounding structures, need for blood transfusion, anesthesia complications, hematoma formation, thromboembolism, and incisional hernia. Apgar score >7 at one and 5 minutes, neonatal intensive care unit, multiple pregnancy rate, premature delivery rate and perinatal death rate, all were similar in the 3 groups.CONCLUSION: Women with multiple CS (>3) are significantly prone to have uterine scar rupture and abnormal placentation in the subsequent pregnancies compared to those with one or 2 previous cesarean deliveries. Despite that, maternal and neonatal outcome did differ from patients with lower-order cesarean sections.