Impact of multiple cesarean deliveries on maternal morbidity: systematic review

January 01, 0001

Impact of multiple cesarean deliveries on maternal morbidity: systematic review

These US authors conducted a systematic review and meta-analysis of observational studies to determine the impact of increasing numbers of cesarean deliveries on maternal morbidity. This study was performed for the 2010 National Institutes of Health Consensus Development Conference on Vaginal Birth After Cesarean: New Insights.

They found: "Twenty-one studies (2,282,922 deliveries) were included. The rate of hysterectomy, blood transfusions, adhesions, and surgical injury all increased with increasing number of cesarean deliveries. The incidence of placenta previa increased from 10/1000 deliveries with 1 previous cesarean delivery to 28/1000 with 3 or more cesarean deliveries. Compared with women with previa and no previous cesarean delivery, women with previa and 3 or more cesarean deliveries had a statistically significant increased risk of accreta (3.3-4% vs 50-67%), hysterectomy (0.7-4% vs 50-67%), and composite maternal morbidity (15% vs 83%; odds ratio, 33.6)."

The authors concluded: "Serious maternal morbidity progressively increased as the number of previous cesarean deliveries increased."

These risks should be weighed against those of trial of labor after cesarean section.


For the full abstract, click here.

Am J Obstet Gynecol 205(3):262.e1-262.e8, September 2011 © 2011 to Mosby, Inc.
Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Nicole E. Marshall, Rongwei Fu, Jeanne-Marie Guise. Correspondence to Dr. Marshall: [email protected]

Category: W. Pregnancy, Family Planning. Keywords: maternal morbidity, multiple cesarean deliveries, previa, meta- analysis of observational studies, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 4 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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