Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Rates of cesarean delivery vary internationally, but generally, it has shown a worldwide increase. Repeat cesarean deliveries was found to be associated with increased maternal morbidity, including placenta previa, placenta accreta, hysterectomy, adhesions, bladder injury, postoperative hemoglobin deficit, and need for blood transfusion. In our study, we evaluated the outcome of emergency cesarean deliveries conducted at Kasr Alaini hospital and the impact of repeated cesarean deliveries on that outcome. We recruited 300 patients admitted at the casualty department and divided equally into 3 groups (100 patients in each group). Groups were as follow: Group 1: Patients with primary cesarean delivery (control group). Group 2: Patients with previous one cesarean delivery. Group 3: Patients with previous two or three or higher order cesarean deliveries. The three groups of singleton pregnancy were compared preoperatively regarding (data sheet, included history, examination and preoperative HB), intra-operatively regarding (operative duration, surgeon, anaesthesia, operative finding and complications), post-operatively regarding (duration of hospital stay, ileus, ICU admission, HB post). In our study, regarding the surgical outcome: The operative duration was statistically significantly longer in patients with previous two or more cesarean deliveries (Group 3) than patients with primary cesarean delivery (group 1) or previous one cesarean delivery (group 2) [74.4, 44.4, 56.4 min respectively, p<0.001]. Also, the hospital stay was statistically significantly longer in group 3 than group 1 or 2. 2.90, 1.29, 1.27 days p<0.001

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