Women who undergo repeated caesarean sections face major risks of complications, researchers warned today.
Problems occur when women have their fifth child by means of the surgical procedure, researchers reported.
Nearly one in five of these women suffered from serious bleeding and needed a blood transfusion, researchers found.
Researchers compared some 94 women who underwent multiple caesareans with another 175 women for the study, reported in BJOG.
The major cause of the increased complications was a problem of abnormal positioning of the placenta – and two thirds of the women with this condition ended up in intensive care after delivery. About half needed a hysterectomy.
Researcher Dr Mandish Dhanjal, of Imperial College Healthcare NHS Trust, London, UK, said: "Multiple repeat caesarean sections are an unusual occurrence and for most women the outcomes are very good.
"However there is a higher risk of maternal complications and preterm delivery compared to women having fewer caesareans.”
Journal deputy editor John Thorp said: "All caesarean section procedures carry risks, some that are life-threatening. Larger studies are needed to look at this in more detail before firm recommendations are made about the maximum number of caesarean sections which should be performed."
The Royal College of Obstetricians and Gynaecologists said the findings highlighted the need for careful discussions with women facing the prospect of having a caesarean delivery.
Spokeswoman Dr Virginia Beckett said: "If a woman has a previous caesarean section she can still go on to have a successful vaginal delivery.
"Women should discuss all the options with their midwife or obstetrician. Despite there being a slightly higher risk of rupture following a previous Caesarean, the procedure itself carries risks such as risk of blood clots, longer recovery period and the potential need for elective caesareans in future pregnancies."
Cook JR, Jarvis S, Knight M, Dhanjal MK. Multiple Repeat Caesarean Section in the UK: Incidence and consequences to mother and child. A national prospective, cohort study. BJOG October 30 2012
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