Perinatal Outcome in Relation to Timing of Cesarean Delivery in Women with Previous Two and More Cesarean Deliveries

Background and objectives: A prior cesarean delivery is the primary indicator of the steadily rising rate of cesarean deliveries. The aims of the study were to determine the timing of elective recurrent caesarean births and evaluation of the perinatal outcomes of elective repeated caesarean deliveries at various gestational ages. Methods: A cross sectional study was conducted in Duhok Obstetrics and Gynecology teaching hospital between May 2022 and May 2023. Singleton pregnancies that had delivered at term via elective cesarean section were included and the number of completed weeks of gestation (37+0–6, 38+0–6, and 39+0–6 weeks) was used to categorize all pregnancies. Results: Out of 500 singleton pregnancies, 44% of them had Cesarean deliveries at 38+0–6 weeks of gestation. The differences in birth weight across gestational ages were statistically significant (P 0.003). As compared with deliveries at 39+0–6 weeks, cesarean delivery at 37+0–6 weeks of gestation had significantly higher risk, including that of neonatal intensive care (P 0.032) and the respiratory problems and O2 support need (P 0.010). The study showed no evidence of infant mortality. Conclusions: The elective cesarean delivery at 39+0–6 weeks of gestation appears to be best time for elective cesarean delivery for women with two or more prior cesareans. With this approach; the risks connected with emergency cesarean deliveries can be reduced and neonatal outcomes can be optimized.