Analysis Of Multiple Cesarean Delivery

Objective:To analyze the maternal complications such as pelvic adhesion,postpartum hemorrhage(PPH),placenta previa and hysterectomy,and neonatal complications in patients with multiple cesarean sections(CS).To explore the epidemiology and obstetric outcomes of multiple cesarean sections.Methods:A retrospective case-control study from January 1st 2011 to December 31 2016 in Women's Hospital School of Medicine Zhejiang University of 402 pregnant women with>3 cesarean sections was compared with a control group of 402 women having 1 cesarean section and another control group of 402 women having 2 cesarean sections.To collect their maternal basic information and various perinatal complications and neonatal situation.To compare the basic situation and obstetric outcomes between the three groups.Results:Inrecent six years,the rate of multiple cesarean delivery has been increasing in our hospital.With the increasing number of cesarean delivery,patient's age increased(P<0.05),surgery time increased gradually(P<0.05),gestational age at delivery advanced(P<0.05);Within the group C,with the increasing number of cesarean delivery,the gestational age at delivery advanced too(P<0.05).There was no significant difference in the thickness of scar between group B and group C(P>0.05).The bleeding in group C was significantly higher than that in group A and group B(P<0.05).With the increasing number of cesarean section,the incidence of pelvic adhesion increased(P<0.05);the incidence of postpartum hemorrhage,placenta previa,placenta accreta and hysterectomy in group C was significantly higher than that in group A and group B(P<0.05).There was no significant difference in the incidence of placental adhesion,GDM,ICP and gestational hypertension between the three groups(P>0.05).With the increasing number of cesarean section,the weight of neonatal decreased(P<0.05).The incidence of preterm birth and the utilization rate of ventilator in group C were significantly higher than those in group A and group B(P<0.05).The incidence of neonatal malformations,neonatal asphyxia and neonatal mortality in group C were significantly higher than those in group A(P<0.05).Conclusion:The rate of Multiple cesarean section increased year by year,the incidence of pelvic adhesion,postpartum hemorrhage,placenta previa,placenta accreta in multiple cesarean section pregnant women was significantly high.Compared with the primary and secondary cesarean section,the incidence of adverse perinatal outcome in multiple cesarean section was significantly higher,clinicians need to attach great importance to this clinical phenomenon.