High order caesarean section: Prevalence and maternal morbidity at Nishtar Hospital Multan.

Abstract

Objective: To determine the prevalence and morbidity associated with high order caesarean section (HOCS). Study Design: Descriptive Study. Setting: Department of Obstetrics & Gynaecology, Nishtar Hospital Multan, Pakistan. Period: January 1, 2018 to December 31, 2019. Material & Methods: A prospective study of all the patients who underwent four or more C-section were included. Maternal morbidity was the primary study objective. The data was collected and analyzed by using SPSS version 19. Results: A total of 7390 caesarean sections were performed, out of these 240 patients (3.24%) underwent HOCS. Two women had their 6th caesarean, while 12 women had their fifth caesarean. There was no maternal death. Most common complications were postpartum haemorrhage requiring blood transfusion (25.8%), obstetric hysterectomy (6.25%), bladder injury requiring repair (5%) and wound dehiscence and wound infection (2.5%). Conclusion: HOCS is associated with increased maternalMmorbidity although there was no mortality. Indications for primary caesarean section should be reviewed to reduce repeat caesarean sections. Moreover, counselling on different methods of contraception during visits to antenatal clinics should be done to limit family size.