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Risk of complications associated with cesarean birth according to the number of cesarean births

Risk of complications associated with cesarean birth according to the number of cesarean births
Number of cesarean births Risk of complications (%)
Placenta accreta Hysterectomy Transfusion Cystotomy Bowel injury Maternal death*
1 (primary cesarean birth) 0.24 0.65 4.05 0.13 0.11 0.19
2 0.31 0.42 1.53 0.09 0.06 0.07
3 0.57 0.90 2.26 0.28 0.13 0.05
4 2.13 2.41 3.65 1.17 0.34 0.07
5 2.33 3.49 4.26 1.94 0.00 0.00
6 6.74 8.99 15.73 4.49 1.12 0.00
In this series, there were 6201 first (primary); 15,808 second; 6324 third; 1452 fourth; 258 fifth; and 89 sixth or more cesarean deliveries.
* Only 2 of the 27 maternal deaths were potentially related to the cesarean birth itself. Both occurred in patients having their second cesarean birth. This study did not have adequate power to determine whether rare but serious events, such as maternal death, increased as the number of cesarean births increased.
Data from: Silver RM, Landon MB, Rouse DJ, et al. Maternal Morbidity Associated With Multiple Repeat Cesarean Deliveries. Obstet Gynecol 2006; 107:1226.
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