Lower Segment Cæsarean Section as a Routine

Caesarean section-past, present and what of the future?

“…This approach was practised by several obstetricians in Europe and the United States of America during the early part of this century but it never really became established practice worldwide. This incision was favoured by German surgeons and was known to be followed by rupture into the bladder with fatal results both during the operation and as a consequence of scar dehiscence in a subsequent pregnancy (Bailey, 1934). In England, small numbers were performed by Blair Bell, Holland and Munro Kerr, (Case ef al., 1971) while in the United States of America, a large series of 731 operations performed between 1915 and 1928 was reported by Greenhill and Bloom (1929) from the Chicago Lying-in Hospital.…”

“…The elliptical incision in the lower segment replaced the transverse incision. as Bailey (1934) had shown that it provided the greatest access and least risk of extending to involve the uterine vessels. He advocated bimanual extraction of the head whilst not deprecating the use of one blade of the forceps to act as a n elevator.…”