Physical and psychological implications in a multiple and preterm caesarean section a case report

Cesarean section (CS) in Italy has continuously increasing rates. Due to the primary CS, the repeated CS have shown a superimposable trend. Consequently, a number of pathologies are related to such surgery among which placenta previa, dehiscence of previous scar, placenta accreta and preterm delivery. The purpose of this case report is to discuss the physical and psychological implications correlated with a very unusual case of a consecutive seventh CS in the same pregnant woman associated with several diseases: preterm delivery, fetal distress, intrauterine growth retardation (IUGR) (- 4 weeks), central placenta previa with metrorrhagia, dehiscence of hysterectomic scar. In spite of the therapy (antifibrinolytic, tocolytic drugs, iron, folates, betamethasone) a preterm CS could not be avoided. Surgery was challenging; hysterectomy was avoided and the mother followed a normal post-operative course, whereas fetal distress and IUGR did not allow the survival of the newborn. A review of the literature regarding the clinical management and psychological aspects of a pregnant woman undergoing multiple complicated CS with the aforementioned disorders will be undertaken.