Abstract
Introduction: Previous caesarean section poses risk to both mother and neonates in the subsequent pregnancy. This study aimed to study the obstetric and neonatal outcome in a pregnancy with previous caesarean section (CS). Methods: A retrospective chart review was conducted in pregnant women with previous CS, admitted from 15thOctober 2020 to 14thApril 2020. Collected data were analyzed regarding maternal and perinatal outcome using appropriate statistics. Results: Among total of 322 cases, vaginal birth after caesarean were conducted in 3.7% and majority 78.2% went through emergency CS, rest were elective. Total CS was done in 96.2%, because 58.7% did not meet VBAC criteria and 40.3% refused VBAC. 36.6% had preterm delivery. Of 310 cases that underwent CS, common complications reported were: intra operative hemorrhage (20), scare dehiscence (12), urinary bladder injury (4), placenta praevia (11), uterine rupture (2), adherent placenta (5), postpartum hemorrhage (PPH) (13), abruptio placentae (6) and hysterectomy (1). 3 mothers required ICU admissions. Complications among neonates were: low birth weight 14.2%, birth asphyxia 3.1%, 5.2% required NICU admissions. (8/322) pregnancy had intra uterine fetal death and there was 1 still birth. Perinatal mortality were higher among female with previous LSCS less than 2 years (p=0.02) and those with more than once LSCS had significant proportion of intraoperative haemorrhage (p=0.01), PPH (p=0.04) and placenta praevia (p=0.04). Conclusions: Delivery among pregnant with previous CS have significant operative challenges and perioperative complications among mother and neonates. Anticipation of common complications and preparedness beforehand could improve both maternal and neonatal outcome.
Key words: Maternal, neonatal, outcome, previous caesarean delivery.