Average maternal hemoglobin decline after first elective cesarean section compared to higher order cesarean sections

Lower uterine segment scarring after cesarean section can decrease intraoperative bleeding during subsequent surgery. The study examined whether the first elective cesarean section is associated with more significant average blood loss than repeated surgery. Although the repeated cesarean section is associated with longer surgery and a higher need for blood transfusion, the average haemoglobin drop is higher after the first cesarean section. Scarring of the lower uterine segment can explain this paradoxical finding.