Abstract
Background
Uterine scar complications remain an important cause of maternal and fetal morbidity in women with a previous cesarean section. Maternal tachycardia has been proposed as a simple bedside clinical sign that may facilitate early recognition of these complications; however, evidence regarding its diagnostic value is limited.
Objective
To determine the association between maternal tachycardia and uterine scar complications in patients with one previous cesarean section undergoing repeat cesarean delivery.
Methodology
This hospital-based case-control study was conducted at the Department of Obstetrics and Gynaecology, Khyber Teaching Hospital, Peshawar, from 1 October 2025 to 31 March 2026. A total of 184 women with one previous cesarean section were enrolled, including 92 cases with maternal tachycardia and 92 controls without maternal tachycardia. Baseline demographic and obstetric characteristics were recorded. Maternal tachycardia was defined as a heart rate >100 beats/minute. Uterine scar complications, including uterine rupture and scar dehiscence, were confirmed intraoperatively. Data were analyzed using SPSS version 24.
Results
Baseline characteristics were comparable between the two groups. Uterine scar complications occurred significantly more frequently among women with maternal tachycardia than those without tachycardia (32.6% vs. 14.1%; p=0.003). Scar dehiscence was the most common complication. Maternal tachycardia was associated with a significantly increased likelihood of uterine scar complications (OR=2.95; 95% CI: 1.43–6.09; p=0.003).
Conclusion
Maternal tachycardia was significantly associated with uterine scar complications in women with one previous cesarean section. As a readily available bedside clinical sign, maternal tachycardia may assist in the early identification of women at increased risk and support timely obstetric intervention. Further prospective multicenter studies are warranted to validate these findings