Caesarean section is one of the ways to give birth to a baby through surgery. It is used in cases where the natural passage of the child through the birth canal poses a high risk to the health of the woman in labor or the newborn, or becomes impossible for any reason. In recent years, the indications for this operation have increased, which is associated with the incidence of caesarean section. With natural childbirth, the risk of maternal mortality exceeds the risk of a cesarean operation by almost 2.5 times! A caesarean section can be planned or emergency. But for this operation, both in the first and in the second case, there are both indications and contraindications.
Indications for a planned cesarean section
A planned cesarean section is prescribed by a doctor for certain indications. The doctor informs the mother in advance about the planned cesarean, usually 8-10 days before the operation. In this case, the timing of the operation is more precisely negotiated in advance by the doctor together with the woman in labor. With a planned cesarean section, a woman in labor is advised to think in advance about the maternity hospital in which she would like to get a job. The absolute indications for a cesarean section are:
- complete or incomplete placenta previa in case of severe bleeding;
- premature placental abruption;
- anatomically narrow pelvis of a woman in labor, or a discrepancy between the size of the pelvis and the weight of the child;
- multiple uterine fibroids, especially large ones;
- varicose veins in the vaginal area;
- the presence of an inconsistent scar on the uterus, or an existing scar after two or more cesarean section operations;
- the presence of some oncological diseases in the woman in labor that block the birth canal;
- previous operations in a woman in labor on the hip joints or pelvis, as well as deformities of the pelvic bones;
- complicated gestosis, accompanied by increased pressure, edema and the presence of protein in the urine;
- Rh-conflict and hemolytic disease of the fetus;
- multiple pregnancy with 3 or more fetuses;
- the presence of severe and chronic diseases of the systems and organs of the pregnant woman;
- transverse position of the fetus;
- scar of the perineum after a rupture of 3 degrees in a previous birth;
- breech presentation of the fetus;
- entanglement of the fetus with the umbilical cord;
- breech presentation or transverse position of one of the fetuses in multiple pregnancies.
Indications for emergency caesarean section
An emergency caesarean section is an unplanned operation. It is carried out in cases when any complications occur during natural childbirth. An emergency caesarean section is performed only with the consent of the woman in labor. If at the time of making the decision, the woman in labor is not legally capable, doctors need the consent of the next of kin for the operation.
The reasons for an emergency caesarean section can be:
- fetal hypoxia, expressed in a decrease in its mobility, as well as in keeping the heartbeat;
- discrepancy between the size of the pelvis of the woman in labor and the weight of the fetus, since the fetus, due to its large size, cannot enter the pelvis;
- incorrect insertion of the fetal head;
- weak labor activity;
- the threat of uterine rupture;
- premature withdrawal of amniotic fluid;
- loss of body parts (arms or legs) or umbilical cord loops;
- the critical condition of the mother with a living fetus;