A study coming out of the UK shows that women undergoing 5 or more cesareans have significantly more complications and preterm deliveries. The study was published in the journal BJOG: An International Journal of Obstetrics and Gynaecology and was a joint effort of Oxford University and Imperial College Healthcare NHS Trust.
The study compared 94 women who had undergone multiple repeat cesarean sections (MRCS),which is defined as having 5 or more, to 175 women who had fewer. The results strongly showed that the MRCS group was associated with a much higher incidence of complications. For instance, major obstetric hemorrhage is a risk for women undergoing cesarean. In the study , 18% of the MRCS group had a major obstetric hemorrhage. Only 0.06% of those with fewer cesareans suffered the hemorrhaging. Also, 17% of the MRCS group received a blood transfusion compared to only 1% of the other group. Another staggering statistic was that the MRCS group was 5 times more likely to deliver preterm than those with fewer cesareans.
Women undergoing multiple repeat cesareans are extremely rare. In fact they only constitute about 1 out of 10,000 deliveries. According to the BJOG press release, Dr Mandish Dhanjal, Department of Obstetrics & Gynaecology, Imperial College Healthcare NHS Trust and co-author of the research said, “Multiple repeat caesarean 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 caesareans…We also found that these risks were greatest in women undergoing MRCS who also had placenta praevia and placenta accreta. Obstetricians should be aware of this high risk group of women and work in multidisciplinary teams in order to optimise their management.”
Larger studies need to be done before recommendations for the maximum amount of cesarean deliveries can be made. In the meantime, it is good for doctors and mothers to know these risks and to take steps in the early term to mitigate future complications.