Prevalence of Spontaneous Labor Pain Prior to Scheduled Cesarean Section in Pregnant Women with Previous Uterine Surgery

Abstract Objectives: To determine the prevalence of spontaneous labor pain prior to a schedule for cesarean section in pregnant women with previous uterine surgery. Maternal and neonatal complications from emergency cesarean deliveries in these women were compared to those in women who had scheduled or elective procedures. Methods: Medical records of pregnant women with previous cesarean section or other uterine operations who underwent cesarean section at Faculty of Medicine Vajira Hospital between January 2004 and December 2006 were reviewed. Data collection included maternal clinical characteristics, maternal and neonatal complications. Results: Total of 830 women met inclusion criteria. Of these, 602 women (72.5%) were scheduled for cesarean delivery at or after 39 weeks of gestation ( ณ 39 +0 weeks). Overall, the operations were done in an emergency setting in 43.6% (362/830 women). The rate of emergency operation was significantly higher in women who had a schedule for cesarean section at or after 39 +0 weeks compared to those who were planned at earlier gestational ages of 37 +0 to 38 +6 weeks (21.1% versus 52.2%, p-value < 0.001) Likewise, the emergency group had a significantly higher rate of low apgar score (4.1% versus 0.5%, p-value < 0.001) and tended to have more newborn intensive care unit admission (1.9% versus 0.6%, p-value = 0.113) as compared to the elective group. Conclusion: Nearly half (43.6%) of women with previous uterine surgery had emergency cesarean section before the schedule. The maternal and neonatal complications were higher in the emergency than the elective groups. Keywords: emergency cesarean section, previous uterine surgery, spontaneous labor pain