Cesarean Section Complications
Conditions
Keywords
Elective cesarean section, Time interval between consecutive cesarean sections
Brief summary
The goal of this observational study is to determine the best time interval between consecutive cesarean sections and compare maternal and neonatal outcomes in women with a history of previous cesarean sections. The main questions it aims to answer are: * What is the optimal time interval between consecutive cesarean sections for minimizing maternal intraoperative complications, blood transfusions, and intra- and postoperative bleeding? * What are the differences in fetal and neonatal outcomes based on different time intervals between cesarean sections? Participants will be divided into five subgroups based on the time interval since their last cesarean section: 0-12 months, 12-24 months, 25-36 months, 37-48 months, and more than 48 months. Each participant will undergo an elective cesarean section and provide data on maternal and neonatal outcomes. Researchers will compare these subgroups to see if varying time intervals between consecutive cesarean sections affect maternal and neonatal outcomes.
Interventions
PROCEDURECesarean Delivery
A Pfannenstiel abdominal incision is made. The skin and rectus sheath are transversely opened using sharp dissection, and the rectus sheath is separated from the underlying rectus abdominis muscles. The peritoneum is then longitudinally opened using sharp dissection. A transverse incision is made in the lower segment of the uterus, which is subsequently closed with two layers of continuous sutures. Both peritoneal layers are closed with continuous sutures. The fascia is closed using either continuous or interrupted sutures. Finally, the skin is closed with either interrupted sutures or a continuous intracutaneous suture.
Sponsors
Al-Azhar University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 42 Years
Healthy volunteers
No
Inclusion criteria
* Age between 20-42 years. * Full-term pregnant women more than 37 weeks gestation. * Women with a history of at least one previous cesarean section, planning an elective repeated cesarean section.
Exclusion criteria
* Women with contraindications to cesarean section * Those with emergency indications * Multiple pregnancies * Pre-existing maternal or fetal conditions affecting outcomes.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative complications | Withen the surgery. | Occurrences of injuries to the bladder or bowel during surgery, injury of uterine artery, extension of uterine incision. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative and postoperative bleeding (quantify blood loss | withen the surgery and up to 24 hours after the sutgery. | Measurement of blood loss before and after surgery using complete blood count (CBC). |
| Blood transfusions | withen the surgery and up to 24 hours after the sutgery. | Instances of maternal blood transfusions during or after surgery. |
| ICU admissions | 1 week after the surgery. | Number of mothers admitted to the Intensive Care Unit (ICU) postoperatively. |
| Fetal distress | during and 24 hours after the surgery. | Instances of fetal distress noted during labor or delivery |
| Neonatal Apgar scores | 5 minutes after birth. | Apgar scores measured at 1 minute and 5 minutes after birth, assessing newborn health. |
| NICU admissions | during and 24 hours after the surgery. | Number of neonates admitted to the Neonatal Intensive Care Unit (NICU). |
| Neonatal morbidity and mortality | during and 2 weeks after the surgery. | Incidence of health issues and deaths among newborns within a specific timeframe post-delivery. |
Countries
Egypt
Outcome results
None listed