Author(s): MACIEJ JÓ?WIK1, MARCIN JÓ?WIK2, PAWE? SZYMANOWSKI2, MICHA? JÓ?WIK2
The aim of the present review was to highlight two separate types of maternal complicationsassociated with the operative termination of pregnancy by Cesarean section (CS): the „old”,primarily related to the technique of laparotomy or to the complications of labor, and the „new”,into which we included: increased incidence of abnormal placentation (placenta previa, pla-centa accreta/increta/percreta), increased incidence of placental abruption, increased inciden-ce of ectopic pregnancies, and vesicouterine fistulas. The high rate of CS over past decades,including CSs on maternal request, promotes both Cesarean deliveries in subsequent pregnan-cies (thus evoking the increase in the number of uterine scars) and, consequently, the inci-dence of abnormal placentation. This second type of complications must reflect in the incre-ased occurrence of serious obstetric sequelae, like perioperative hemorrhage, shock, or evenmaternal death. In the light of the data discussed, the wish of the pregnant woman to have her first child delivered by CS on request needs to be considered as a trigger to the sequenceof clinical hazardous events which significantly increase her health risks in subsequent pre-gnancies. Hence, such a decision should be considered as clearly unbeneficial. We are wit-nessing a shift in the occurrence of postCesarean complications: old complications decrease,and new complications are on the rise.