Caesarean section is recommended when vaginal delivery might pose a risk to the mother or baby. C-sections are also carried out for personal and social reasons on maternal request in some countries.
Medical uses
Complications of labor and factors increasing the risk associated with vaginal delivery include:
abnormal presentation (breech or transverse positions).
prolonged labor or a failure to progress (obstructed labour, also known as dystocia)
fetal distress
cord prolapse
uterine rupture or an elevated risk thereof
hypertension in the mother or baby after amniotic rupture (the waters breaking)
tachycardia in the mother or baby after amniotic rupture (the waters breaking)
placenta problems (placenta praevia, placental abruption or placenta accreta)
failed labor induction
failed instrumental delivery (by forceps or ventouse (Sometimes, a trial of forceps/ventouse delivery is attempted, and if unsuccessful, the baby will need to be delivered by caesarean section.)
large baby weighing > 4,000 grams (macrosomia)
umbilical cord abnormalities (vasa previa, multilobate including bilobate and succenturiate-lobed placentas, velamentous insertion)
Other complications of pregnancy, pre-existing conditions, and concomitant disease, include:
pre-eclampsia[11]
previous (high risk) fetus
HIV infection of the mother with a high viral load (HIV with a low maternal viral load is not necessarily an indication for caesarean section)
Sexually transmitted diseases, such as a first outbreak of genital herpes very recently before the onset of labor (which can cause infection in the baby if born vaginally)
previous classical (longitudinal) caesarean section
previous uterine rupture
prior problems with the healing of the perineum (from previous childbirth or Crohn’s disease)
bicornuate uterus
rare cases of posthumous birth after the death of the mother
Other
Decreasing experience of accoucheurs with the management of breech presentation. Although obstetricians and midwives are extensively trained in proper procedures for breech presentation deliveries using simulation mannequins, there is decreasing experience with actual vaginal breech delivery, which may increase the risk.[12]
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