Cesarean section is the commonest obstetrical procedure done worldwide. Increase in incidence of cesarean delivery has made it one of the commonest surgical procedure. In previous cesarean deliveries, repeated cesarean section is also increasing, this leads to an increase in various complications like adhesion, blood loss etc.; the scarring and adhesion formation is known to increase the major complications rate.
Objective: The present study was done to observe the per operative findings in repeat cesarean section patients, and to tabulate the surgical difficulties faced by surgeon during handling of such surgeries.
Methods: A prospective, observational study was conducted in the Department of obstetrics and gynaecology, Mayo Institute of Medical Sciences, Barabanki; after obtaining clearance from the institutional ethical committee. Total 100 cases of previous cesarean section were included for calculation convenience. Intra operative findings were recorded. The data was obtained in a semi structured performa.
Results: The most common indication for repeat cesarean section in the present study was fetal distress (18%); the maximum number of patients (85%) were having previous one cesarean section; and in most of them <500 ml blood loss was estimated. The most common adhesion pattern observed were bladder to uterus (28%) followed by parietal peritoneum to omentum (20%).
Conclusions: The incidence of adhesions, blood loss etc increase with repeated cesarean section; this further leads to increase in incidence of complications. To minimise the morbidity and mortality of the patients, repeat cesarean section should preferably be planned as an elective procedure.