Association between repeat cesarean section and adhesion of 100 patients: A cross sectional study in a tertiary care hospital in Bangladesh

Abstract

Background: Caesarean Section (CS) births are on the rise around the world. Many births following a previous cesarean section (CS) are done via repeat surgery, either through an elective CS or after a failed attempt at natural labor. Increased maternal morbidity is linked to the production of adhesions in individuals who have had several cesarean sections. Objectives: To evaluate the association between repeat cesarean section and adhesion. Materials and Method: This cross-sectional descriptive study was conducted in the department of Obstetrics & Gynaecology, Rangpur medical college hospital, Rangpur from July ’18 to June ‘20 after acceptance and ethical clearance of the protocol. During data collection total admitted patient were 2123 out of which 446 caesarean section was done among them 100 patients of my study population were selected by fulfilling inclusion and exclusion criteria. After full explanation, informing the details of the purpose of the study informed written consent was obtained from the study subjects/ or her legal gardian. After Meticulous history taking thorough physical examination was done on every patient and available investigations according to the need of management was done in the hospital. Per operative and postoperative complications were noted. Information’s were collected in predesigned questionnaire and presented in tabulated form and that was finally was analyzed with the help of computer program SPSS (Statistical Package for Social Science) version 23. Result: 2123 patients were hospitalized during my data collection, 446 had caesarean sections, and 100 had repeat surgeries. In 22.4% of instances, repeat cesareans were done. 35% of respondents were aged 25 to 30. Gestational age averaged 36 to 40 weeks. In 79% of instances, an emergency caesarean section was done; in 21%, an elective one. 68 percent of patients had adhesion, 38% had uterine atonicity, 26% had damage to the surrounding structure, 7% had placenta previa, and 3% had morbid placental adhesion. Transfusions and adhesiolysis were done in 34% and 21% of instances. Conclusion: Repeat caesarean increases intraoperative and postoperative complications include adhesion, placenta previa, morbid adherent placenta, PPH, wound infection, and maternal morbidity. To decrease morbidity and mortality, well-trained physicians and experts at well-equipped institutions should do C/S.