BACKGROUND:In Present days caesarean section is the commonest obstetric procedure done worldwide. Incidence of caesarean section is increasing giving it a term’ repeat caesarean section’. During repeat caesarean section abdominal exploration becomes risky. Scarring and adhesion formation, is known to increase the major complication rate from 4.3% to 12.5% in repeat caesarean section. Maternal and foetal complications in subsequent caesarean section are increasing with the rising rate of primary caesarean section worldwide. The aim of this study is to evaluate indication of repeat caesarean section, intra operative difficulties and fetomaternal outcome in repeat caesarean section.

OBJECTIVES : To study prevalence, common indication for repeat caesarean section, intra operative difficulties and fetomaternal outcome in cases of repeat caesarean section.

STUDY DESIGN: A randomized retrospective study was conducted in obstetrics and gynaec department at tertiary care teaching hospital. Total 250 cases of repeat caesarean section were included. The case histories, intra operative findings and fetomaternal outcome  were recorded and analysed.

RESULTS: This study shows that majority of patients were gravida 2(48%) with previous one CS(78%). common indication for repeat caesarean section was foetal distress(24%) followed by cephalo pelvic disproportion(16%).Scar dehiscence were seen in 8% cases while scar rupture had notified in 2 cases. Intra peritoneal adhesions of varied types were seen in majority of cases. Maternal complications like excessive blood loss, fever, wound infections and neonatal complications like prematurity and infections were noted.

CONCLUSION: The risk of scar rupture resulting into adverse fetomaternal outcome leads to increase rate of repeat caesarean section. Repeated caesarean section increases the risk of intra operative difficulties like adhesions and blood loss increases with each caesarean section, which leads to increase in morbidity of woman. Thus indication of primary CS should be justified properly and all the antenatal cases with previous CS should be monitored carefully.