Cesarean delivery on request: reproductive consequences.
OBJECTIVE
The objective of this review is to examine the long term reproductive health consequences of cesarean delivery on maternal request.


RESULTS
In the first delivery, cesarean delivery appears to hold small risk of reproductive complications compared to vaginal delivery. Primary cesarean delivery can affect subsequent pregnancies. The most serious reproductive health consequences of prior cesarean delivery occur in subsequent pregnancies. These complications include: unexplained fetal death apparent from 34 weeks gestation onward; abnormalities of placentation which increase with a greater number of cesarean deliveries; risk of uterine rupture and uterine scar dehiscence.


CONCLUSIONS
Primary cesarean delivery carries risk for subsequent pregnancies. While the studies reviewed do not specifically refer to cesarean delivery on request, it is likely that the results would be similar. Overall, in considering the specific question of long term reproductive health, the risks of maternal request cesarean delivery outweigh the benefits.
Gilliam
Melissa
M
Section, Family planning and contraceptive research, Department of Obstestrics and Gynecology, The University of Chicago, Chicago, IL 60637, USA. mgilliam@babies.bsd.uchicago.edu
D002585:Cesarean Section / Q000009:adverse effects*; D015331:Cohort Studies; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D005313:Fetal Death; D006801:Humans; D016017:Odds Ratio; D010298:Parity; D010358:Patient Participation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors