THURSDAY, Nov. 1 (HealthDay News) -- Pregnant women who've had
multiple cesarean deliveries are at increased risk for
complications and preterm deliveries, a new study finds.
For the study, British researchers compared 94 women who had
five or more cesarean-section deliveries (called multiple repeat
cesarean sections) with 175 women who had fewer C-sections. Women
in the multiple C-section group were much more likely to have major
obstetric hemorrhage (bleeding before, during or after delivery
where blood loss exceeds 1,500 milliliters), blood transfusions,
preterm delivery, and admission to critical care units.
Major obstetric hemorrhage occurred in 18 percent of the women
in the multiple C-section group and 0.6 percent of the other women,
and blood transfusions were required by 17 percent of the women in
the multiple C-section group and 1 percent of the other women, the
Women in the multiple C-section group were also more likely to
have a preterm delivery (24 percent versus 5 percent), according to
the study, published online and in the Oct. 31 print issue of
BJOG: An International Journal of Obstetrics and
Eighteen percent of the women in the multiple C-section group
were diagnosed with placenta previa and/or placenta accreta,
conditions where the placenta is abnormally positioned in the womb
during pregnancy. These women had an even higher risk of
complications than other women who had multiple C-sections, and
half of them required a hysterectomy and two-thirds required
critical care after delivery.
"Multiple repeat cesarean sections are an unusual occurrence and
for most women the outcomes are very good. However, there is a
higher risk of maternal complications and preterm delivery compared
to women having fewer cesareans," study co-author Dr. Mandish
Dhanjal, of the obstetrics and gynecology department at Imperial
College Healthcare NHS Trust, said in a journal news release.
"We also found that these risks were greatest in women
undergoing [multiple repeat cesarean sections] who also had
placenta previa and placenta accreta. Obstetricians should be aware
of this high-risk group of women and work in multidisciplinary
teams in order to optimize their management," Dhanjal added.
John Thorp, journal deputy editor-in-chief, pointed out that
more research is needed on these high-risk deliveries.
"It is important that both women and obstetricians are aware of
the complications associated with repeat cesarean sections. All
cesarean-section procedures carry risks, some that are
life-threatening. Larger studies are needed to look at this in more
detail before firm recommendations are made about the maximum
number of cesarean sections which should be performed," Thorp said
in the news release.
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