Maternal Morbidity in Repeat Cesarean Deliveries and Associated surgical challenges

Abstract

Background: Cesarean delivery (CD) is one of the most commonly performed obstetric procedures worldwide, with a steadily increasing rate that exceeds the recommended levels by international health organizations. While CD has become relatively safe due to advances in surgical techniques, anesthesia, and perioperative care, it remains associated with significant maternal morbidity. The risk of complications increases progressively with repeat cesarean deliveries, including hemorrhage, adhesions, surgical injuries, and placental abnormalities such as placenta previa and placenta accreta spectrum. Additionally, emergency cesarean sections are associated with higher intraoperative and postoperative complications compared to elective procedures due to less controlled conditions and increased maternal and fetal stress. Understanding the surgical challenges and associated maternal risks in repeat cesarean deliveries is essential to improve outcomes and guide clinical decision-making.