Analysis Of Related Complications Of Repetitive Cesarean Section And Its Influence On Maternal And Infant Outcomes

Objective: By analyzing the different number of cesarean section surgery related complications in the perinatal period and the effect on maternal and infant outcomes were analyzed,expound cesarean delivery operation rate and complications related to the operation in the perinatal period and mother son ending of correlation,for clinical scar uterus women,especially women repeated cesarean section again pregnancy health care and the diagnosis and treatment to provide guidance in the perinatal period,Also can effectively reduce the clinical cesarean section rate.Methods: A retrospective case-control study was conducted to select pregnant women who delivered by cesarean section in affiliated Hospital of Youjiang Medical College for Nationalities from January 1,2019 to December 31,2021.According to inclusion and exclusion criteria,eligible women were divided into groups according to the number of cesarean sections.there are more than three times and cesarean section surgery for maternal multiple cesarean section surgery group,is set to GROUP C,There were 206 cases in total,606 cases in GROUP B.The above two groups were repetitive cesarean operation groups,200 cases in women with first cesarean operation at the same period were randomly selected as GROUP A,and the single cesarean operation group was used as control group.The medical records of pregnant women in three groups were collected,including manual of prenatal examination,records of delivery,records of cesarean section,records of postpartum care and discharge records.The preoperative general information of pregnant women in each group was observed,including age,weight,haemoglobin,preoperatie pregnancy complicated with diabetes and gestational hypertension.Intraoperative and postoperative general conditions:emergency surgery rate,duration of surgery,gestational week of surgical delivery,length of hospital stay,24-hour blood loss;Postoperative complications including postpartum bleeding,intestinal obstruction,postoperative infection,poor healing of the operative mouth,surrounding organ injury.Postoperative long-term complications including placenta previa,placenta implantation,placental abruption,uterine rupture,pelvic adhesion.Neonatal situation including premature infants,low birth weight infants,neonatal asphyxia and neonatal transfer rate.SPSS25.0 data analysis software was used for statistical analysis of the above indicators,to compare the difference between the three groups of maternal surgical complications and maternal and infant outcomes.Results:(1)There was a difference in gestational age among the three groups(P < 0.0167),GROUP A was younger than GROUP B,and GROUP B was younger than GROUP C;There was no difference in preoperative weight,hemoglobin level,incidence of gestational diabetes mellitus and gestational hypertension(P > 0.05).(2)There were significant differences among the three groups in incidence of emergency surgery,gestational age,duration of surgery and 24 hours postpartum blood loss(P < 0.0167).In the incidence of emergency cesarean section,GROUP A was higher than GROUP C,and GROUP C was higher than GROUP B.The gestational age of GROUP A was larger than GROUP B,and GROUP B was larger than GROUP C.In terms of operation duration,GROUP A was less than GROUP B,and GROUP B was less than GROUP C.24 hours postpartum blood loss in GROUP A was less than GROUP B,GROUP B was less than GROUP C.In the interval of cesarean section between GROUP B and GROUP C,the interval of cesarean section in GROUP B was longer than that in GROUP C.(3)There was significant difference in the incidence of postpartum hemorrhage among the three groups(P < 0.05),while there was no difference in the incidence of postoperative intestinal obstruction,infection,injury of surrounding organs and poor healing of the operative mouth(P > 0.05).The incidence of postpartum hemorrhage in the three groups was compared between the two groups,GROUP A was smaller than GROUP C,but there was no significant difference in the incidence between GROUP A and GROUP B or between GROUP B and GROUP C(P > 0.0167).(4)The long-term complications after repetitive cesarean section were compared between GROUP B and GROUP C,and there were significant differences in the incidence of placenta implantation,uterine rupture and pelvic adhesion between the two groups(P < 0.05),and GROUP B was less than GROUP C.There was no significant difference in the incidence of placenta previa and placental abruption(P>0.05),and there was no difference in the incidence of placenta previa,uterine rupture,placenta implantation,placental abruption and pelvic adhesion at different cesarean intervals(P > 0.05).(5)There were no significant differences in the incidence of premature birth,neonatal asphyxia,low birth weight and neonatal transfer among the three groups(P > 0.05).Conclusion:(1)Repetitive cesarean section is not an influential factor of postoperative intestinal obstruction,infection,poor healing of the operative wood and injury of surrounding organs.It has little effect on the short-term complications after cesarean section and does not prolong the hospital stay.(2)The number of cesarean sections mainly affects the occurrence of postoperative long-term complications,and is not affected by the time interval between cesarean sections,resulting in increased risk of placenta previa,placenta implantation,uterine rupture and pelvic adhesion in the next pregnancy.It is difficult to perform the operation again,and the risk is high,resulting in prolonged operation time and earlier gestational age of surgical delivery.(3)The related complications of repetitive cesarean section are mainly adverse effects on the mother,which will increase the maternal bleeding within 24 hours after delivery.Compared with one cesarean section,three or more cesarean sections will significantly increase the incidence of postpartum hemorrhage.(4)Repetitive cesarean section is not a factor of adverse neonatal outcomes.