Maternal consequences of caesarean section - A retrospective study of intra-operative and postoperative maternal complications of caesarean section during a 10-year period

Objectives: This study was performed to assess the intra-operative surgical complications and postoperative maternal morbidity rate of caesarean section. Study design: A total of 2647 women, delivered by caesarean section in our department between 1983 and 1992, were studied retrospectively. Three caesarean section groups were formed: (1) primary elective, (2) primary acute, without any effort to deliver vaginally, and (3) secondary acute, due to a failed vaginal delivery. The Student's-t-, Fisher-exact- and X-2-test were used for statistical analysis. Rusults: The overall maternal intra-operative complication rate was 14.8%. The most common complications were lacerations of the uterine corpus (10.1%) and bloodless greater than or equal to 1000 ml (7.3%). The complication rate of the secondary group (23.4%) was significantly higher (p<0.001) compared to both primary groups (7.4%). The overall maternal postoperative morbidity rate was 35.7%. Fever (24.6%), bloodless between 1000 and 1500 ml (4%), haematoma (3.5%) and urinary tract infections (3.0%) were the most frequent complications. The primary elective group showed significantly (p<0.001) lower major (2.6%) and minor (23.7%) complication rates compared to the emergency groups (major 5.2%, minor 34%). Conclusion: Emergency caesarean sections carried the greatest risks regarding maternal complications compared to elective procedures. (C) 1997 Elsevier Science Ireland Ltd.