Nasreen Kishwar, Samia Shuja, Afia Ansar, Fouzia Ghaus.
Frequency of Peroperative Morbidity among One versus More Caesarean Section.
Pak J Med Health Sci Jan ;7(3):777-81.

Aim: To determine the frequency of peroperative morbidity in women with at least previous one caesarean section and compare peroperative morbidity in women with repeated caesarean section versus previous singleton caesarean section. Methods: This cross-sectional study was carried out at the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre Karachi, from May 2010 to November, 2010. Patient with the past history of one or more LSCS fulfilling the inclusion criteria were enrolled in the study. Patients were admitted in the ward one day before surgery. Surgeries were performed by researcher herself under supervision of consultant having post fellowship experience of more than 5 years. Outcome of repeat caesarean section was measured in terms of peroperative morbidity of dense adhesions and extremely thinned out lower uterine segment. Results: A total of 150 patients were enrolled, Out of them 73 patients (48.7%) had history of one caesarean section previously whereas 77 patients(55.3%) had history of repeat caesarean section(>one caesarean section previously).Dense adhesions were found in 123 (82%) women, of them 55 patients (75.3%) were in single caesarean section group and 68 patients (88.3%) in repeat caesarean section group and result was found to be statistically significant (p=0.0390).on the other hand, extremely thinned out lower uterine segment was found in 83 women(55.3%), of them 40 women (54.8%) were in single caesarean section group and 43 women (55.8%) were in repeat caesarean section group , result was not statistically significant. Conclusion: Prevalence of dense intra abdominal adhesions was higher in women with history of more previous caesarean section than in women with one previous section.

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