Cesarean Section

About Cesarean Section

Cesarean section is the surgical delivery of a baby through incisions in the abdominal wall and the uterus. It is one of the most commonly performed operations in the world, and rates vary widely between countries, with concern about both underuse in low resource settings and overuse elsewhere. The World Health Organization has noted that above a certain level, higher cesarean rates are not associated with further reductions in maternal and newborn deaths at the population level. The usual technique uses a low transverse Pfannenstiel skin incision, separation of the rectus muscles and a low transverse incision in the lower uterine segment, known as the Kerr incision, which heals well and carries a lower risk of rupture in later pregnancies. A vertical classical uterine incision is reserved for special situations, such as some very preterm deliveries or unusual fetal positions, and carries a higher rupture risk in future labor. After delivery of the baby and placenta the uterus is closed in one or two layers. Indications include labor that fails to progress, signs of fetal distress, breech or transverse presentation, placenta previa, some multiple pregnancies, certain maternal infections and previous uterine surgery. Complications include hemorrhage, infection, injury to the bladder or bowel and blood clots, and later pregnancies carry increased risks of placenta accreta. Many people can attempt a vaginal birth after cesarean, which carries a small risk of uterine rupture. The operation is usually performed under spinal or epidural anesthesia, allowing the mother to be awake for the birth.