• The obstetric histories of 130 patients who had had four or more cesarean sections were obtained from 20 hospitals. The period from 1936 to 1945 furnished only 14 cases of this kind, but from 1946 to 1955 there were 112.
In 42 cases the main indication given for cesarean section was that the patient had had one or more already. Low cervical cesarean section was the operation most often done. In the 130 recent sections studied, the two kinds of anesthesia most frequently used were spinal anesthesia (56) and nitrous oxide and ether (24). A study of blood losses during the operation gave no evidence that subsequent sections were accompanied by any more bleeding than previous sections had been.
The data show some increase in prematurity in more recent sections and indicate anxiety on the part of the operator to avoid the risk of rupture near term. No conclusion is drawn concerning the relative safety of vaginal deliveries after cesarean sections, but the capabilities of the uterus after multiple sections have been underestimated.
McNally HB, Fitzpatrick VDP. PATIENTS WITH FOUR OR MORE CESAREAN SECTIONS. JAMA. 1956;160(12):1005–1010. doi:10.1001/jama.1956.02960470001001
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