The impact of cesarean section and its complications on fertility rates

The aim: to evaluate the relationship between performed caesarean section operations and complications influencing on fertility rates. Materials and methods. A total of 393 patients aged 19 to 43 years old have been examined to conduct aretrospective cohortre search. Some of their social and biological data, obstetric-gynecological anamnesis peculiarities (including extragenital diseases, development and complications of previous pregnancies), results of clinical, instrumental and laboratory examinations have been studied. Authenticity of difference between two independent groups in terms of qualitative characteristics was determined using Pearson's chi- square test (χ 2 ) (with Yates correction for small samples-df) by compiling four-field contingency tables. When performing analytical statistics, the following levels of significance of differences were established: p < 0,05; p < 0,01; p < 0,001. The statistical significance of the established relationship was being determined using the definition of relative risk (RR, relative risk) and 95 % confidence interval (CI, confidence interval). Results. After performed caesarean sections in the examined women non-developing pregnancy was being observed 1.9 times more often than in the comparison group in patients who gave birth through the natural birth canal (p = 0,003, RR = 1,886; CI = 1,061–3,351). Inflammatory diseases of the genitals in the main group (PID) were registered 1.7 times more often than in the comparison group (p < 0,001, RR = 1,667; CI = 1,290–2,156). It should be especially noted that after the completion of the first pregnancy by CS, repeated similar interventions were performed 6,5 times more often (p < 0,001, RR = 6,466; CI = 4,968–8,416). Other surgical interventions on the abdominal organs were performed 2,7 times more often than in the comparison group (p = 0,003, RR = 2,669; CI = 1,402–5,080). No less significant is the fact that proliferative diseases of the internal organs such as uterine myoma and endometriosis were being developed respectively 2 (χ 2 = 4,454, p = 0,035, RR = 2,062; CI = 1,052–4,508) and 4 times more often (χ 2=4,598, p = 0,033, RR = 4,311; CI = 1,281–14,508) than in patients of the comparison group. Conclusion. The completion of the reproductive debut by abdominal delivery is associated with a significant risk of developing PID, non-developing pregnancy, proliferative diseases of the uterus (myoma, endometriosis), necessity in performing repeated CS operations and other surgical interventions on abdominal organs.

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