Open AccessSurgical complications after caesarean section: A population-based cohort study
Author(s) -
Charlotta Larsson,
Elin Djuvfelt,
Anna Lindam,
Katarina Tunón,
Pär Nordin
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0258222
Subject(s) - caesarean section , medicine , incisional hernia , obstetrics , bowel obstruction , population , pregnancy , surgery , abdominal pain , hernia , genetics , environmental health , biology
Background The rate of caesarean section without medical indication is rising but the risk for surgical complications has not been fully explored. Methods Altogether 79 052 women from the Swedish Medical Birth Register who delivered by caesarean section only from 2005 through 2016 were identified and compared with a control group of women delivering vaginally only from the same register and the same period of time. By cross-linking data with the National Patient Register the risks for bowel obstruction, incisional hernia and abdominal pain were analysed, as well as risk factors for these complications. We also analysed acute complications, uterine rupture, and placenta praevia. Findings Caesarean section is associated with an increased risk for bowel obstruction (OR 2.92; CI 2.55–3.34), surgery for bowel obstruction (OR 2.12; CI 1.70–2.65), incisional hernia (OR 2.71; CI 2.46–3.00), surgery for incisional hernia (OR 3.35; CI 2.68–4.18), and abdominal pain (OR 1.41; CI 1.38–1.44). Smoking, obesity, and more than one section delivery added significantly to the risk for these complications. Interpretation Caesarean section is considered a safe procedure, but awareness of the risk for serious complications is important when deciding on mode of delivery. In this study, more than one section, obesity and smoking significantly increased the risk for complications after caesarean section. Prevention of smoking and obesity among fertile women worldwide must continue to be a high priority.