The management of multiple pregnancy in women with a lower-segment caesarean scar. Is a repeat caesarean section really the 'safe' option?
Multiple pregnancy occurring in a patient who has previously had a lower-segment caesarean section is an unusual sequence of events. Retrospective analysis over an 11-year period in Sheffield from 1975 to 1985, revealed 25 cases, a rate of 1 in 3300 deliveries. The caesarean section rate in this group of women rose from 20% (3/15) in the first six years to 70% (7/10) in the latter years for no obvious reason. This change in management did not produce any improvement in fetal outcome but there was an increase in maternal morbidity. This analysis and a review of available literature suggest that multiple pregnancy is not in itself an indication for elective repeat caesarean section.
Gilbert
L
L
Department of Obstetrics and Gynaecology, Northern General Hospital, Sheffield.
Saunders
N
N
Sharp
F
F
D002585:Cesarean Section; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011183:Postoperative Complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D012086:Reoperation; D013997:Time Factors