Cesarean Delivery

Abstract

Cesarean delivery rates rose from 20 to 33% of births in the United States from 2006-2009 without an accompanying improvement in neonatal outcomes. The cesarean rate may be safely decreased by increasing vaginal birth after cesarean, encouraging external cephalic version for breech presentation, maintaining operative vaginal delivery skills, and applying stricter criteria for operative intervention in labor dystocia. A variety of cesarean operative techniques are supported by randomized controlled trials. Optimal maternity care outcomes depend on sound medical decision-making, appropriate operative technique and skills, and effective communication between maternity care team members.

Cesarean Section: Incidence, Causes, Associated Factors and Outcomes: A National Prospective Study from Jordan

“…The reason provided by participating women for preference of CS was simply to avoid pain of vaginal delivery. On the other hand, in a previous study of maternal morbidity in Jordan The increase in cesarean delivery rates overtime has not been associated with improvements in neonatal outcomes [34]. In the present study, the neonatal death rate was significantly higher in planned CS and emergency CS, as compared to vaginal delivery.…”

MRI of Acute Gynecologic Conditions

“…Cesarean section is performed in approximately one‐third of live births in the United States, with an overall postoperative complication rate of 36% . Although rare, uterine dehiscence is a well‐documented complication, with an estimate rate of occurrence of 0.2–4.3%, with prior cesarean section being the greatest risk factor .…”

Anterior uterine wall: normal and abnormal CT and MRI findings after cesarean section

“…Pfannenstiel transverse skin incision, which has been in use since the early 1900s, is a commonly utilized surgical approach made popular when first described by Monro Kerr in 1926 (3). Joel-Chen incision is a different surgical technique that was reported to cause less morbidity compared with Pfannenstiel approach (3). The main difference between these two techniques is the location of the skin incision (Fig.…”

“…1). The usual incision site in Pfannenstiel incision is 2 fingerbreadths above the pubic symphysis, while it is 3 cm below the line between the anterior-superior iliac spines in Joel-Cohen incision (3). After the skin incision, the underlying fascia is dissharply opened and the rectus muscle is dissected and separated.…”

“…A transverse incision is preferred over a vertical incision as there is lower risk of uterine rupture in subsequent pregnancies, less blood loss, and a lower risk of bladder rupture. After this step the baby is delivered by applying pressure on the fundal segment of the uterus, which is followed by the delivery of the placenta (3). The uterine incision is then sealed with double-layer closure approach over single layer closure as the risk of uterine rupture is lower with the former (5).…”