Delivery after previous cesarean: long-term maternal outcomes.
Most studies of cesarean morbidity focus on short term, rather than long term complications. However, women undergoing cesarean delivery are at increased risk for a chronic problems as well. These include pain and surgical adhesions, as well as a possible increased risk for infertility or sub-fertility and perinatal complications in subsequent pregnancies. The most serious risk for women undergoing multiple repeat cesarean deliveries is a dramatically increased risk for life threatening hemorrhage and morbidity in the setting of placenta accreta. This chapter outlines these long term risks of cesarean delivery so that they may be factored into the risk:benefit ratio for women considering vaginal birth after cesarean delivery (VBAC).
Silver
Robert M
RM
University of Utah School of Medicine, Department of Obstetrics and Gynecology, Salt Lake City, UT 84132, USA. bsilver@hsc.utah.edu
D017604:Cesarean Section, Repeat / Q000009:adverse effects*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007247:Infertility, Female / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology; D017699:Pelvic Pain / Q000453:epidemiology; D010921:Placenta Accreta / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011271:Pregnancy, Ectopic / Q000453:epidemiology; D018570:Risk Assessment; D000267:Tissue Adhesions / Q000453:epidemiology; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects*