Maternal consequences of caesarean section. A retrospective study of intra-operative and postoperative maternal complications of caesarean section during a 10-year period.
OBJECTIVE
This study was performed to assess the intra-operative surgical complications and postoperative maternal morbidity rate of caesarean section.


METHODS
A total of 2647 women, delivered by caesarean section in our department between 1983 and 1992, were studied retrospectively. Three caesarean section groups were formed: (1) primary elective, (2) primary acute, without any effort to deliver vaginally, and (3) secondary acute, due to a failed vaginal delivery. The Student's-t-, Fisher-exact- and chi 2-test were used for statistical analysis.


RESULTS
The overall maternal intra-operative complication rate was 14.8%. The most common complications were lacerations of the uterine corpus (10.1%) and bloodloss > or = 1000 ml (7.3%). The complication rate of the secondary group (23.4%) was significantly higher (p < 0.001) compared to both primary groups (7.4%). The overall maternal postoperative morbidity rate was 35.7%. Fever (24.6%), bloodloss between 1000 and 1500 ml (4%), haematoma (3.5%) and urinary tract infections (3.0%) were the most frequent complications. The primary elective group showed significantly (p < 0.001) lower major (2.6%) and minor (23.7%) complication rates compared to the emergency groups (major 5.2%, minor 34%).


CONCLUSIONS
Emergency caesarean sections carried the greatest risks regarding maternal complications compared to elective procedures.
van Ham
M A
MA
Department of Gynaecology and Obstetrics, University Hospital Nijmegen St Radboud, The Netherlands.
van Dongen
P W
PW
Mulder
J
J
D002585:Cesarean Section / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D005334:Fever; D006406:Hematoma / Q000453:epidemiology; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D007744:Obstetric Labor Complications; D011183:Postoperative Complications / Q000453:epidemiology*; D011247:Pregnancy; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000453:epidemiology; D014599:Uterus / Q000293:injuries