妊娠与儿童健康杂志

抽象的

The Effect of Primary Cesarean Section on Subsequent Delivery

Elie Nkwabong , Kayawa Monglo Stéphane and Mbu Robinson Enow

Objective: To evaluate the effect of the first cesarean section (CS) on the subsequent delivery.

Methods: This prospective cohort study was carried out in two major hospitals of Yaoundé, Cameroon, from November 1st, 2013 to April 30th, 2014. Maternity records at second delivery of parturient whose first delivery was done by CS (primary CS) or vaginally was compared. The main variables recorded included maternal age, intergenesic period, gestational age at delivery, mode of delivery, birth weight, uterine rupture and post-partum haemorrhage. Data were analyzed using Epi info 3.5.4. Fisher exact test and t-test were used for comparison. P<0.05 was considered statistically significant.

Results: There was no statistically significant difference between means concerning maternal ages, intergenesic periods, gestational ages at delivery and birth weights. Women with primary CS had an increased risk of uterine rupture (one case versus none), repeat CS (RR 5.1, 95%CI 2.5-10.4, P<0.0001) and post partum bleeding ≥500ml (RR 6.3, 95%CI 2.0-20.0, P<0.0002).

Conclusion: Primary cesarean delivery was associated with a higher risk of repeat CS. Given that repeat CS is associated with subsequent elective CS, efforts should concentrate mainly on the reduction of primary CS rate to reverse the rising CS rate.