From the Research
The optimal timing for a repeat cesarean section (CS) after a short interval pregnancy is generally recommended to be at least 18 months from the previous cesarean delivery, with the procedure typically scheduled at 39 weeks gestation, as supported by the most recent study 1. For pregnancies with intervals shorter than 18 months, the timing should be individualized based on the specific circumstances, but generally should not be performed before 37 completed weeks unless medically indicated. Some key points to consider include:
- If the inter-pregnancy interval is very short (less than 6 months), special consideration should be given to the increased risks of uterine rupture, surgical complications, and placental abnormalities, as noted in 2.
- In these cases, the cesarean might be scheduled between 37-38 weeks after confirming fetal lung maturity.
- Antenatal corticosteroids (betamethasone 12 mg IM given as two doses 24 hours apart, or dexamethasone 6 mg IM given as four doses 12 hours apart) should be administered if delivery is anticipated before 39 weeks, as this can help reduce the risks associated with premature birth.
- The uterine scar typically takes 6-9 months to develop full strength, making pregnancies conceived shortly after cesarean delivery particularly vulnerable to complications, as discussed in 3 and 4.
- It is essential to weigh the risks of premature birth against the risks of uterine rupture and other complications when determining the optimal timing for a repeat cesarean section after a short interval pregnancy.
- A study from 2025 1 found that previous cesarean section was associated with an increased risk of both spontaneous preterm birth and postterm birth, but the more appropriate survival models only showed an association between cesarean section and longer gestational duration of the subsequent pregnancy.
- Another study from 2018 4 found that cesarean delivery was associated with decreased risk of urinary incontinence and pelvic organ prolapse, but increased risk of asthma and obesity in children, as well as increased risk of placenta previa, placenta accreta, and placental abruption in subsequent pregnancies.
- Overall, the decision on the timing of a repeat cesarean section after a short interval pregnancy should be made on a case-by-case basis, taking into account the individual patient's medical history, current health status, and personal preferences, as well as the potential risks and benefits of different timing options, as discussed in 5.