Cesarean delivery of a fetus is viable through the abdominal wall incision and uterine incision. The practice is since antiquity, but it was used to extract the children of women who died.
The Caesarean section has continued to grow in recent years and is still growing, for several reasons:
1) As surgery-related morbidity and mortality decline as a result of anesthetic techniques, the number of cesarean increases in the following situations:
* Wider use of electronic fetal monitoring led to an increasing number of caesarean sections for fetal distress;
* Growing trend to postpone pregnancy leads to a greater number of older primipara. First pregnancy and advanced age is associated with increased rate of cesarean birth complications;
* There is a tendency of more liberal distociei recommendation that surgical indication, with a corresponding decrease in applications forceps;
* There is a steady and marked decline in the number of vaginal births.
2) A history of caesarean section is an indication for its repetition.
Under what conditions is recommended a C-section ?
There is clear evidence that a rise in Caesareans lead to a decrease in perinatal mortality and morbidity, therefore, from this point of view, cesarean section is not necessarily a benefit. Aside from physical comfort and physical benefit (absence of painful uterine contractions) of the mothers, the benefits of caesarean section (representing the benefit to the mother, fetus or both), overlap cesarean indications. These include:
1. Disorders of the birth canal:
* Tumor praevia (an ovarian cyst or fibroids in the pelvis);
* Vaginal or cervical stenosis are rarely indications for cesarean section;
* Double uterus, where it acts as a tumor negravid uterus praevia;
* Cesarean Surgery is sometimes needed after surgery to repair fistula, a tearing of the perineum.
2. Dystocia presentations;
3. Abnormal uterine activity (dystocia expansion);
4. Antepartum haemorrhage:
* Placenta previa (C-section is the best approach, both the mother and the fetus);
* Detachment of the placenta (abruptio placentae).
5. Other maternal indications: cardiac and respiratory diseases; preeclasmpsie, eclampsia or hypertensive disorders, diabetes mellitus, active genital herpes infection, history of cesarean section; miomectromie opening of the uterine cavity.
6. Fetal Indications: intrauterine growth retardation of fetal distress, Rh isoimmunization, poor antenatal testing.
7. Urgent conditions requiring immediate cesarean section: placental detachment or intrapartum hemorrhage, cord prolapse, poor evolution of the BCF, intrapartum fetal acidosis, uterine rupture, maternal death imminent.
It is estimated that maternal mortality after caesarean section is 7 times higher than vaginally birth.