Multiple Cesarean Section Outcomes and Complications: A Retrospective Study in Jazan, Saudi Arabia

Background: Given the increase in the rate of cesarean sections (CSs) globally and in Saudi Arabia, this study was conducted to assess the maternal and perinatal complications after repeat cesarean sections in the studied population. Methods: This retrospective study was conducted by reviewing the records of all women who underwent CSs between January and July 2023 in three hospitals in the Jazan region of Saudi Arabia. Results: Of the 268 women studied, 195 (72.7%) had a CS for the first or second time and 73 (27.3%) had two, three, or four previous CSs (repeat CS). The most common maternal intra-operative complications reported by the repeat CS group were intra-peritoneal adhesions (7.5%) and fused abdominal layers (7.1%) while the most common postoperative complications were the need for blood transfusion (22%) and UTIs (3%). The most common neonatal complications were a low Apgar score (19%), needing neonatal resuscitation (2.6%), and intensive care admission. In addition, 3.7% of mothers failed to initiate breastfeeding in the first 24 h. Conclusions: The frequent complications were intra-peritoneal adhesions, fused abdominal wall layers, blood transfusion, and postoperative infections which were overcome by the optimal hospital care. However, the frequent neonatal complications were a low Apgar score, needing neonatal resuscitation, and intensive care admission.