Gynecology & Obstetrics
Open Access

Abstract

Are Higher Order Caesarean Sections More Risky Compared to Lower Order Caesarean Sections?

Zaheera Saadia

Background: Saudi Arabian culture encourages large families, and therefore, it’s not uncommon to see women undergo several Caesarean Sections (CS). There is disagreement in the literature regarding the actual risks mothers face with higher order CSs.

Aim: This study aims to explore whether more frequent higher order CSs result in more complications.

Materials and methods: This study was a retrospective cohort study conducted at the Mother and Child Hospital in Burayda, Al Qassim, Saudi Arabia, between 31st January and 31st March 2012. Group 1 had undergone three or fewer CSs, and Group 2 had undergone more than three CSs. Comparisons between the mean values of the quantitative variables were calculated using the Student t test for quantitative data, and a chi-square for qualitative data. The test of significance was set at 0.05.

Results: The CS rate for this time period was 28.6%. In all, 193 (56.3%) women were in Group 1, and 150 women (43.7%) were in Group 2. Sixty-nine women (46%) had four previous CSs; 58 (38.7%) had five; 20 (13.3%) had six; and three women (2%) had seven previous CSs. The presence of complications, such as intra operative adhesions, adherent placenta, placenta previa, postpartum haemorrhage (PPH), wound infection, urinary tract infection and deep vein thrombosis, were higher in Group 2 (P<0.05).

Conclusions: Higher order CSs are associated with higher complication rates. The precise scale of the trend of performing higher order CSs needs to be studied, and appropriate strategies at the national level should be implemented to encourage family planning.