A study warns about the risks associated with having multiple Cesarean Deliveries

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A recent publication in the Qatar Medical Journal reveals that women who undergo multiple cesarean deliveries face a heightened risk of maternal surgical complications. The study also points out an increased likelihood of babies born to these women being admitted to the neonatal intensive care unit (NICU) and experiencing respiratory distress syndrome (RDS).

The research, conducted in a tertiary maternity hospital in Qatar, was prompted by the global surge in cesarean section rates, often driven by a history of prior cesarean deliveries. Cesarean deliveries (CD) currently make up nearly 1 in 5 live births worldwide and are projected to rise to almost 30% by 2030. The escalating primary cesarean rate subsequently results in more women undergoing repeat CDs, as a prior cesarean is a common indication for an elective CD.

In the Middle East, the reported CD rate is as high as 40.6%, with studies from Qatar indicating a CD risk of 25-30%, rising to 46% in mothers with gestational diabetes. The study examined the health records of over 6,000 pregnant women with one or more prior cesarean deliveries, with 41.3% having a primary CD. The cohort included those who underwent their second (30.3%), third (17.5%), and fourth (7.3%) CD, while women with five or more CDs were grouped together, contributing only 3.6%.

The study, titled "Maternal and neonatal outcomes associated with multiple repeat cesarean deliveries: A registry-based study from Qatar," emphasizes that women with multiple cesareans face an increased risk of maternal surgical complications, including adhesions, visceral injury, pelvic hematomas, return to the operating room, sepsis, and postpartum hemorrhage. The morbidity is notably higher in women undergoing five or more CDs, whether elective or emergency.

As the number of cesareans increases, women are more likely to give birth before completing the full term of 39 weeks. Neonates born to women with multiple CDs also have an elevated risk of complications, even in planned elective deliveries at term.

The study underscores the importance of informing women about the substantial morbidity associated with multiple CDs and suggests offering contraceptive advice. Considering the tendency for planned early-term deliveries in this high-risk group, the study proposes the consideration of providing antenatal corticosteroids for fetal lung maturity to reduce neonatal morbidity.

Source: The Peninsula