Caesarean section Health Dictionary

An operation to deliver a baby from the uterus through a horizontal or, less commonly, a vertical

incision in the abdomen. A caesarean section is performed when it is difficult or dangerous to deliver a baby vaginally. The procedure is performed using epidural or general anaesthesia.

The operation used to deliver a baby through its mother’s abdominal wall. It is performed when the risks to mother or child of vaginal delivery are thought to outweigh the problems associated with operative delivery. One of the most common reasons for Caesarean section is ‘disproportion’ between the size of the fetal head and the maternal pelvis. The need for a Caesarean should be assessed anew in each pregnancy; a woman who has had a Caesarean section in the past will not automatically need to have one for subsequent deliveries. Caesarean-section rates vary dramatically from hospital to hospital, and especially between countries, emphasising that the criteria for operative delivery are not universally agreed. The current rate in the UK is about 23 per cent, and in the USA, about 28 per cent. The rate has shown a steady rise in all countries over the last decade. Fear of litigation by patients is one reason for this rise, as is the uncertainty that can arise from abnormalities seen on fetal monitoring during labour. Recent research suggesting that vaginal delivery is becoming more hazardous as the age of motherhood rises may increase the pressure from women to have a Caesarean section – as well as pressure from obstetricians.

The operation is usually performed through a low, horizontal ‘bikini line’ incision. A general anaesthetic in a heavily pregnant woman carries increased risks, so the operation is often performed under regional – epidural or spinal – ANAESTHESIA. This also allows the mother to see her baby as soon as it is born, and the baby is not exposed to agents used for general anaesthesia. If a general anaesthetic is needed (usually in an emergency), exposure to these agents may make the baby drowsy for some time afterwards.

Another problem with delivery by Caesarean section is, of course, that the mother must recover from the operation whilst coping with the demands of a small baby. (See PREGNANCY AND LABOUR.)

a surgical operation for delivering a baby through the abdominal wall. The operation most commonly performed is lower uterine segment Caesarean section (LUSCS), carried out through a transverse incision in the lower portion of the uterus (see lower uterine segment). Classical Caesarean section, in which the upper segment of the uterus is incised vertically, is now rarely performed. In addition to its use in cases of obstructed labour, *malpresentation (breech, brow, and shoulder), and in severe *antepartum haemorrhage, Caesarean section is being performed increasingly when the baby is at risk and is exhibiting signs of distress. Because of improved techniques in perinatal care, particularly of the preterm baby, the operation may be performed, if necessary, as soon as the child is viable.