Lower segment Cesarean section

Cesarean section is the ultimate method of successful delivery of infants under various circumstances and is an indispensable operation in obstetrics. However, the degree of difficulty varies greatly depending on the gestational weeks, number of fetuses, number of previous cesarean sections, degree of placental adhesion, presence of uterine myomas, maternal obesity, and other factors. In addition, emergency cesarean section is a battle against time, and prompt surgery is required.

During training in cesarean section, surgeons must master the basic techniques in cases of term head presentation first. They must then master the techniques in cases involving complications such as malpresentation, preterm birth, placenta previa, abruptio placentae, uterine myomas, and other conditions.

 

Cesarean section itself is a simple operation. However, there are many difficult cases, and many complications such as placenta accreta and defects of the incision scar may occur after cesarean section.

Indications for Cesarean Section

Two types of cesarean section are performed: elective and emergency cesarean section. The absolute indications and relative indications are as follows.


Absolute Indications

Absolute indications are cephalopelvic disproportion, placenta previa, abruptio placentae, transverse lie, triplet pregnancy, mechanical obstruction of vaginal birth (large uterine myoma or ovarian tumor), prolapsed umbilical cord, vasa previa, human immunodeficiency virus-infected pregnancy, and other conditions.


Relative Indications

Relative indications are non reassuring fetal status, maternal complications (e.g., hypertensive disorder in pregnancy or cardiac disease), twin pregnancy, breech presentation, and other conditions.