Previous cesarean section and the risk of postpartum maternal complications and adverse neonatal outcomes in future pregnancies.
OBJECTIVE
To assess maternal postpartum and neonatal outcomes associated with previous method of delivery.


METHODS
We analyzed prospectively collected maternal and neonatal data from July 2002 to December 2003. Data were collected from dedicated perinatal database and neonatal database from discharge and procedure codes. Groups were: (i) multiparous, prior vaginal delivery (VD), and (ii) multiparous, prior cesarean (CS). This group was subdivided by subsequent pregnancy trial or no trial of labor (No TOL). Results were compared with chi (2)-analysis; significance P<0.05.


RESULTS
There were 17 406 births. Prior CS patients without trial of labor (TOL) required more blood transfusions, intensive care unit admissions and hospital readmissions than women with a prior VD. Prior CS patients with TOL required more aminoglycosides for postpartum infection. Term neonates of (CS) mothers without a TOL were more likely to have prolonged hospitalization and require ventilatory support.


CONCLUSIONS
In their subsequent delivery, women with a prior CS delivery are at significant risks for postpartum maternal and neonatal morbidities compared with parous patients who experienced a prior VD.
Galyean
A M
AM
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine University of California Irvine, Orange, CA, USA. annagalyean@gmail.com
Lagrew
D C
DC
Bush
M C
MC
Kurtzman
J T
JT
D001803:Blood Transfusion / Q000706:statistics & numerical data; D002140:California; D002585:Cesarean Section / Q000706:statistics & numerical data*; D017604:Cesarean Section, Repeat / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000209:etiology*; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D010298:Parity; D010343:Patient Admission / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000453:epidemiology* / Q000209:etiology*; D011645:Puerperal Infection / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000706:statistics & numerical data; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology; D014219:Trial of Labor; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data*