An Overview on Complications of Cesarean Section

Abstract

Cesarean section (CS) is one of the most frequently performed obstetric surgical procedures worldwide and plays a crucial role in reducing maternal and fetal morbidity and mortality when vaginal delivery is not feasible. However, the increasing global rate of cesarean delivery has been accompanied by a growing recognition of both short-term and long-term postoperative complications. These complications may include hemorrhage, infection, thromboembolic events, adhesions, abnormal uterine bleeding, infertility, and uterine rupture in subsequent pregnancies. One of the most important long-term sequelae is the formation of a cesarean scar niche (isthmocele), which represents defective healing of the uterine incision and may lead to gynecological symptoms and adverse obstetric outcomes. Understanding the mechanisms of uterine wound healing, the pathophysiology of niche formation, and the influence of surgical techniques—particularly in situ repair versus uterine exteriorization—is essential for improving surgical outcomes and reducing long-term morbidity associated with cesarean delivery.