DOI: 10.36347/sjams.2016.v04i02.004

Pages: 303-310

Caesarean section (CS) is the most common surgery done in obstetric practice. After any laparotomy, it is fairly common to develop scar tissue, adhesions and bladder extension, CS holds no exception to this. Multiple CS is associated with more difficult surgeries with increased blood loss compared with a planned second CS. This is a hospital based, observational comparative study held in Jubilee mission hospital, Thrissur from March 2014-March 2015 which includes women who undergoes CS for first time and those who had undergone previous one or more CS. There were 100 cases of primary CS and 100 cases of repeat CS in the study population. In the primary CS group 79% had no complications while 21% had complications including postpartum haemorrhage and extension of uterine incision. While in the repeat CS group 54% had no complications while the rest had a variety of complications including adhesions (34%) , thin lower uterine segment (17%), extension of uterine incision(3%) and 2 cases of placenta accreta. requiring obstetric hysterectomy. Though the incidence of complications increased with number of CS, the incidence of adhesions and placenta previa was found to have no relation with increasing CS while the incidence of thin lower uterine segment and placenta accreta increased with increasing number of CS. Complications in emergency CS was found to be more than in elective CS and the most common encountered one was excessive bleeding. Thus it can be concluded that repeat caesarean sections are associated with increased morbidity. The best way to reduce this is to reduce the primary section rates.