title: Are multiple repeated cesarean sections really as safe?
abstract: OBJECTIVE
  Surgical complications were compared between patients with three or less prior cesarean deliveries and four or more prior cesarean deliveries.
  
  
  METHODS
  Records of 120 patients who had undergone cesarean sections (CSs) in our Department of Obstetrics and Gynecology, between August and November 2015, were retrospectively studied. Cases were reviewed on the basis of age, type of operation, type of anesthesia, number of CSs, time of hospitalization, and intra-operative and post-operative complications.
  
  
  RESULTS
  Cesarean sections had been performed on 62 (51.7%) patients whose cesarean number was three or less, while 58 (48.3%) patients had multiple CSs four or more. Patients with four or more prior cesareans had an increased rate of intra-abdominal adhesions, compared with the other group. There was no significant difference in the gestational weeks, neonatal admission rate, incidence of cesarean hysterectomy, uterine scar rupture, placenta previa with placental invasion anomalies, bladder and bowel injuries, incidence of peripartum hemorrhage and blood transfusion rate between the two groups.
  
  
  CONCLUSIONS
  There is no greater risk of maternal complications in patients with four or more prior cesareans, excepting intra-abdominal adhesions.
authors.affiliation: a Department of Obstetrics and Gynecology , Medical Faculty, Harran University , Sanliurfa , Turkey.
authors.forename: Hacer
authors.initials: H
authors.lastname: Uyanikoglu
authors.affiliation: b Department of Anesthesiology and Reanimation , Medical Faculty, Harran University , Sanliurfa , Turkey , and.
authors.forename: Mahmut Alp
authors.initials: MA
authors.lastname: Karahan
authors.affiliation: a Department of Obstetrics and Gynecology , Medical Faculty, Harran University , Sanliurfa , Turkey.
authors.forename: Ahmet Berkiz
authors.initials: AB
authors.lastname: Turp
authors.affiliation: a Department of Obstetrics and Gynecology , Medical Faculty, Harran University , Sanliurfa , Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Agar
authors.affiliation: a Department of Obstetrics and Gynecology , Medical Faculty, Harran University , Sanliurfa , Turkey.
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Tasduzen
authors.affiliation: c Department of Obstetrics and Gynecology , Siverek Medicine Hospital , Sanliurfa , Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Sak
authors.affiliation: a Department of Obstetrics and Gynecology , Medical Faculty, Harran University , Sanliurfa , Turkey.
authors.forename: Muhammet
authors.initials: M
authors.lastname: Erdal Sak
mesh_terms: D000328:Adult; D017604:Cesarean Section, Repeat / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology*; D011247:Pregnancy; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000453:epidemiology; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
keywords: Complications; maternal risk; multiple cesarean