• Alper Biler, Atalay Ekin, Aykut Ozcan, Abdurrahman Hamdi Inan, Tayfun Vural, and Emrah Toz.
• Alper Biler, Department of Obstetrics and Gynecology, Tepecik Training and Research Hospital, Izmir, Turkey.
• Pak J Med Sci. 2017 Sep 1; 33 (5): 1074-1079.

ObjectiveTo compare the obstetric outcomes of cesarean section in women who had a history of four or more previous cesarean sections with those who had a history of two or three previous cesarean sections.MethodsTotal 1318 women who underwent repeat cesarean section between January 2013 and January 2016 were retrospectively reviewed. Of these, 244 (18.5%) had previously had four or more cesarean sections (multiple repeat cesarean section group) and 1074 (81.5%) had previously had two or three cesarean sections (control group). Demographic characteristics and obstetric outcomes were compared using the Independent t and chi-square tests.ResultsThe adhesion rate (p < 0.001), number of blood transfusion (p = 0.044), operation time (p = 0.012), length of hospital stay (p < 0.001) and tubal ligation surgery (p < 0.001) were significantly higher in multiple repeat cesarean section group compared to control group.ConclusionAlthough multiple repeat cesarean section are asscociated with adhesion occurrence, higher number of blood transfusion, increased operation time and length of hospital stay, there is no remarkable difference in serious morbidity associated with multiple repeat cesarean section.

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