What are the expected outcomes following cesarean delivery (C-section)?

Updated: Dec 14, 2018
  • Author: Hedwige Saint Louis, MD, MPH, FACOG; Chief Editor: Christine Isaacs, MD  more...
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Answer

Answer

Patients who undergo cesarean delivery usually take slightly longer to fully recover than those who have a vaginal delivery. However, the overall long-term condition of the patient is not adversely affected. Occasionally, some patients can experience pelvic pain associated with intra-abdominal adhesions, a situation that can be aggravated in those who have multiple procedures.

The most important things for patients to know about their cesarean delivery are why they had one and what kind of incision was performed on the uterus.

If a patient had a cesarean delivery for presumed cephalopelvic disproportion, then attempting a vaginal birth with the next pregnancy is associated with a decreased chance of success. Overall, patients attempting a vaginal birth after a prior cesarean delivery can expect success approximately 70% of the time. If the cesarean delivery was performed because of an abnormal fetal heart pattern or for a malpresentation, then expectations for a successful vaginal birth can be higher than 70%.

If the uterine incision was vertical, the risk of uterine rupture is increased above the approximate 1% risk associated with a low transverse incision. If the incision was confined to the lower segment, many physicians allow patients to attempt a vaginal birth in subsequent pregnancies. However, if the incision extended into the upper contractile portion, the risk of uterine rupture can approach 10%, with 50% of these occurring prior to the onset of labor. [18]

A previous cesarean delivery can increase the risk of developing placenta accreta if placenta previa is present in any subsequent pregnancies. The risk of placenta accreta in a patient with previa is approximately 4% with no prior cesarean deliveries; the risk increases to approximately 25% with 1 prior cesarean delivery and to 40% with 2 prior cesarean deliveries. [59]


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