Section Health Dictionary

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.)... caesarean section

A study that measures the prevalence of health outcomes or determinants of health, or both and other variables of interest in a population at a point in time or over a short period.... cross-sectional study

A method of preparing a biopsy specimen that provides a rapid indication of whether or not a tissue, such as a breast lump, is cancerous. Frozen section can be undertaken during an operation so that the results can be used to determine the appropriate surgical treatment.... frozen section

A commonly used term to describe the implementation of a section of the Mental Health Act.... sectioning

any technique that produces an image in the form of a section through the body with the structures cut across. The main techniques are *ultrasonography, *computerized tomography, *magnetic resonance imaging, and some *nuclear medicine techniques (see positron emission tomography; SPECT scanning). If a series of thin-section images is stacked they can be ‘cut’ through to show other planes or allow reconstruction of three-dimensional images.... cross-sectional imaging

(parental order) a court order made under the Human Fertilisation and Embryology Act 1990 that enables a married couple to be regarded as the legal parents of a child born to a *surrogate mother commissioned by that couple. Application must be made within six months of the child’s birth and the child’s home must be with the husband and wife at the time of the application.... section 30 order

a section of the National Assistance Act 1948 that enables a local authority to arrange for the compulsory removal to a place of care of a person who is unwilling to go voluntarily from his or her own home. Individuals who are suffering from a grave chronic disease, or are physically incapacitated, or are living in insanitary conditions because of old age or infirmity can be removed if they are unable to care for themselves and do not receive care and attention from others. A public health consultant and another registered medical practitioner (usually the patient’s general practitioner) must certify that removal is in the interests of the patient or that it would prevent injury to the health of, or serious nuisance to, other people.... section 47 removal