cesarean section , also known as C-section or caesar, , is the use of surgery to give birth to one or more babies. Cesarean section is often necessary when vaginal delivery will harm the baby or the mother. This may include labor jams, multiple pregnancies, high blood pressure in the mother, breech birth, or problems with the placenta or umbilical cord. Cesarean delivery can be done based on the mother's pelvic shape or history of the previous C-section. A vaginal delivery trial after a caesarean is possible. The World Health Organization recommends that caesarean section be performed only when medically necessary. Some C-sections are performed without medical reasons, at the request of a person, usually a mother.
C-section usually takes 45 minutes to an hour. This can be done with a spinal block in which the woman is awake or under general anesthesia. Urine catheter is used to dry the bladder and abdominal skin and then cleaned with antiseptic. An incision of about 15 cm (6 inches) is then usually done through the lower abdomen of the mother. The uterus is then opened with a second incision and the baby is born. The incision is then sewn closed. A woman can usually start breastfeeding as soon as she gets up and leaves the operating room. Often a few days are needed in the hospital to recover sufficiently to return home.
C-section results in a small overall increase in poor outcomes in low-risk pregnancies. They also usually take longer to heal from, about six weeks, than the birth of the vagina. Increased risk includes respiratory problems in infants and amniotic fluid embolism and postpartum haemorrhage in the mother. The established guidelines recommend that caesarean section not be used before 39 weeks' gestation without medical reason. The delivery method does not seem to affect the subsequent sexual function.
In 2012, about 23 million C-section is done globally. The international health care community previously considered the 10% and 15% rates ideal for caesarean section. Some evidence found a higher rate than 19% can yield better results. Over 45 countries globally have a C-section rate of less than 7.5% while over 50 have rates of more than 27%. There are efforts to improve access and reduce the use of C-section. In the United States by 2017, about 32% of deliveries are made by caesarean section. The operation has been carried out at least as far back as 715 BC after the death of the mother with the occasional baby survived. Description of the surviving mother dates back to the 1500s. With the introduction of antiseptics and anesthesia in the 1800s the survival of both mother and baby became common.
Video Caesarean section
Usage
Cesarean section is recommended when vaginal delivery may pose a risk to the mother or baby. C-section is also done for personal and social reasons. A systematic review found no firm evidence of the effect of caesarean section for non-medical reasons. Recommendations encourage counseling to identify reasoning requests, address anxiety and information, and encourage normal birth. An elective Caesarean section at 38 weeks showed an increase in health complications in the newborn. For this reason, a planned caesarean section (also known as elective caesarean section) should not be scheduled before 39 weeks of pregnancy unless there is a medical reason to do so.
Medical use
Complications of labor and factors increase the risk associated with vaginal delivery, such as:
- abnormal presentation (breech or transverse position). Babies are usually born head first. If the baby is in another position, labor may be complicated. In 'breech presentation', the unborn baby is bottom-down instead of head-down. Babies born at the bottom are more likely to be harmed during a normal (vaginal) birth than the first born baby. For example, a baby may not get enough oxygen during birth. Performing a planned caesarean section can reduce this problem. A review looking at a cesarean section for a single buttock presentation with a planned vaginal birth, concluded that in the short term, a planned caesarean birth is safer for the baby than the vaginal birth. Fewer babies die or are seriously injured when they are delivered by caesarean section. However, there is tentative evidence that children born by caesarean section have more health problems at the age of two years. Caesarean section causes some short-term problems for the mother such as abdominal pain. They also have several benefits, such as fewer urinary incontinence and fewer perineal pain.
- old or failing labor (dystocia)
- fetal disturbance
- cable prolaps
- uterine rupture or increased risk
- maternal or infant hypertension after rupture of membranes (broken water)
- maternal or infant tachycardia after rupture of membranes (broken water)
- placental problems (placenta pravia, placenta or placenta accreta)
- induction of labor failed
- failed instrumental delivery (by forceps or ventouse (Sometimes a forceps/ventouse delivery attempt is tried, and if unsuccessful, the baby needs to be delivered by cesarean section.)
- big baby with weight & gt; 4.000 grams (macrosomia)
- cord abnormalities (vasa previa, multilobate including bilobate and placenta succenturiate-lobed, velamentus insertion)
Other complications of pregnancy, pre-existing conditions and comorbidities, such as:
- pre-eclampsia
- the previous fetus (high risk)
- Maternal HIV infection with high viral load (HIV with low maternal viral load is not always an indication for cesarean section)
- Sexually transmitted diseases, such as the first recent genital herpes outbreak just before the onset of labor (which can cause infections in infants if born through the vagina)
- previous caesarean section (longitudinal)
- previous uterine rupture
- previous problems with perineal healing (from previous labor or Crohn's disease)
- Bicornuate uterus
- A rare case of birth after delivery after maternal death
Other Reducing the experience of actresses with asset presentation management - Although obstetricians and midwives are trained extensively in appropriate procedures for sending presentation offenses using a simulated mannequin, there is a decrease in experience with actual vaginal breech delivery that may increase the risk further.
Prevention
It is generally agreed that the prevalence of caesarean section is higher than that required in many countries and doctors are encouraged to actively lower the rate, since a cesarean rate higher than 10-15% is not associated with a reduction in maternal or infant mortality. Some evidence supporting a higher rate of 19% can yield better results.
Some of these efforts are: emphasizing a long and latent work phenomenon not abnormal and not a justification for a cesarean; a new definition of the onset of active labor from cervical dilatation of 4 cm to 6 cm dilation; and allow at least 2 hours of encouragement for women who had previously given birth and 3 hours of encouragement for women who had never given birth before the capture of labor was considered. Physical exercise during pregnancy also reduces the risks.
Maps Caesarean section
Risk
Adverse outcomes in low-risk pregnancies occurred in 8.6% vaginal delivery and 9.2% cesarean delivery.
Mother
In those at low risk, the risk of death for a caesarean section is 13 per 100,000 and for vaginal birth 3.5 per 100,000 in developed countries. The National Health Service of the United Kingdom poses death risk to mothers tripled from vaginal births but it is important to remember that the actual risk of death in both situations is very small in resource-rich settings.
In Canada, the difference in serious maternal morbidity or mortality (eg heart attack, wound hematoma, or hysterectomy) is 1.8 additional cases per 100. The difference in maternal deaths in hospitals is not significant.
Cesarean section is associated with the risk of postoperative adhesion, an incisional hernia (which may require surgical correction) and wound infection. If a cesarean section is performed in an emergency, the risk of surgery may increase due to a number of factors. The patient's abdomen may not be empty, increasing the risk of anesthesia. Other risks include severe blood loss (which may require blood transfusions) and post-puncture spinal pain.
Wound infections occur after caesarean section at a rate of 3-15%.
Women who undergo caesarean section are more likely to have problems with pregnancy at a later date, and it is recommended that women who want a large family should not seek elective cesarean section unless there is medical indication to do so. The risk of placenta accreta, a potentially life-threatening condition that is likely to develop where a woman had a previous caesarean section, was 0.13% after two caesarean sections, but increased to 2.13% after four and then to 6.74% after six years. or more. Along with this is a similar increase risk of emergency hysterectomy during childbirth.
Mothers may experience an increased incidence of postnatal depression, and may experience significant psychological trauma and post-traumatic stress disorder associated with birth after obstetric interventions during labor. Factors such as pain in the first stage of labor, feelings of helplessness, disturbing emergency obstetric interventions are important in the subsequent development of psychological issues related to childbirth.
Next pregnancy
Women who undergo caesarean section for any reason are less likely to get pregnant again than women who previously only gave birth through the vagina, but the effect is small.
Women who had only one previous caesarean section were more likely to have problems with their second birth. Delivery after previous caesarean section is one of two main options:
- Vaginal birth after cesarean section (VBAC)
- Elective cesarean section (ERCS)
Both have a higher risk than normal birth without previous cesarean section. There are many issues to consider when planning a delivery for each pregnancy, not only that complicated by a previous caesarean section and there is a list of some of these issues in the list of indications for the section in the first part of this article. Vaginal delivery after cesarean section (VBAC) causes a higher risk of uterine rupture (5 per 1000), blood transfusion or endometritis (10 per 1000), and perinatal child mortality (0.25 per 1000). Furthermore, 20% to 40% of the planned VBAC effort ends at a required caesarean section, with a greater risk of complications in recurrent emergency cesarean section than in the elective cesarean section. On the other hand, VBAC provides less maternal morbidity and reduced risk of complications in future pregnancies rather than repeated elective caesarean section.
Adhesion
There are a number of steps that can be taken during abdominal or pelvic surgery to minimize postoperative complications, such as adhesion formation. Such techniques and principles may include:
- o Handle all networks with absolute care
- o Using powder-free surgical gloves
- o Controlling bleeding
- o Selecting stitches and implants carefully
- o Keeps the moisture of the network
- o Prevent infection with antibiotics administered intravenously to the mother before skin incision
However, regardless of these proactive measures, adhesion formation is a recognized complication of any abdominal or pelvic surgery. To prevent adhesion from forming after a caesarean section, adhesion barrier can be inserted during surgery to minimize the risk of adhesion between the uterus and the ovaries, small intestine, and almost any tissue in the abdomen or pelvis. This is not the current UK practice as there is no solid evidence to support the benefits of this intervention.
Adhesion can cause long-term problems, such as:
- o Infertility, which may end when adhesion distorts the tissues of the ovaries and tubes, inhibiting the normal path of the egg (ovum) from the ovaries to the uterus. One in five cases of infertility may be related to adhesion (stoval)
- o Chronic pelvic pain, which can occur when adhesion is present in the pelvis. Nearly 50% of cases of chronic pelvic pain are thought to be related to adhesion (stoval)
- o Small bowel obstruction - normal bowel flow disorder, which can occur when adhesion rotates or attracts the small intestine.
The risk of adhesion formation is one of the reasons why vaginal delivery is usually considered safer than elective cesarean section where there is no medical indication for the part for maternal or fetal reasons.
Child
Birthmarks that are not medically indicated (elective) before 39 weeks of pregnancy "carry significant risks for infants with no known benefit to the mother." Complications of elective Caesarean section before 39 weeks include: Newborn death at 37 weeks can reach 3-fold at 40 weeks, and increase compared with 38 weeks of pregnancy. This "early" birth is associated with more deaths during infancy, compared to 39 to 41 weeks ("full term"). Researchers in one study and another review found many benefits to undergo a full-term, but "no side effects" in maternal or infant health.
The American Congress of Obstetricians and Gynecologists and medical policy-makers reviewed research studies and found more incidents of suspected or proven sepsis, RDS, hypoglycemia, the need for respiratory support, the need for admission of NICU, and the need for hospitalization; 4-5 days. In the case of a caesarean section, the respiratory death rate was 14 times higher in pre-delivery at 37 compared with 40 weeks' gestation, and 8.2 times higher for a pre-labor of cesarean at 38 weeks. In this review, no study has found a reduction in neonatal morbidity due to non-medically (elective) delivery before 39 weeks.
For healthy twin pregnancies, where both twins will undergo vaginal birth examination is recommended between 37 and 38 weeks. Vaginal delivery, in this case, does not worsen the outcome for the baby either compared to a caesarean section. There is some controversy about the best labor method in which the first twin is the first head and the second is not, but most obstetricians will recommend a normal labor unless there are other reasons to avoid vaginal birth. When the first twins do not head down, a cesarean section is often recommended. Regardless of whether the twins were born through the passage or through the vagina, medical literature recommended delivery of dichorionic twins at 38 weeks, and monochorionic twins (identical twins sharing placenta) with 37 weeks due to an increased risk of stillbirth in monochorionic twins who remained in utero after 37 weeks. The consensus is that premature births of late monochorionic twins are justified because the risk of stillbirth for post-37 weeks' birth is significantly higher than the risk posed by short-term monochorionic twins (ie, 36-37 weeks). The consensus on monoamniotic twins (identical twins who share amniotic sacs), the highest risk type of twins, is that they should be delivered by caesarean section at or soon after 32 weeks, because the risk of intrauterine death from one or both twins is higher. after this pregnancy rather than the risk of complications of prematurity.
In a widely published study, single children born earlier than 39 weeks may have developmental problems, including slower reading and math learning.
Other risks include:
- wet lung: fluid retention in the lungs may occur if not expelled by contractionary pressure during labor.
- Potential for early childbirth and complications: Preterm labor may be inadvertently performed if the maturity date is inaccurate. One study found an increased risk of complications if elective cesarean section was repeated even a few days before the recommended 39 week recommendation.
- Higher mortality of infant mortality: In a caesarean section performed without indicated medical risk (single at full time in a head down position with no obstetric or medical complications), the risk of death in the first 28 days of life has been cited as 1.77 per 1,000 live births among women who underwent a caesarean section, compared with 0.62 per 1,000 for women who delivered through the vagina.
Cesarean delivery also appears to be associated with worse health outcomes later in life, including overweight or obesity and immune system problems.
Classification
The cesarean section has been classified in various ways by different perspectives. One way to discuss all classification systems is to group them based on their focus on either the urgency of the procedure, the characteristics of the mother, or as a group based on other less commonly discussed factors.
It is most common to classify Caesarean section by urgency of caesarean section.
By urgency
Conventionally, caesarean section is classified as elective surgery or emergency surgery. Classification is used to assist communication between midwifery, obstetrics and anesthesia teams for discussion of the most appropriate anesthetic methods. The decision whether to undertake general anesthesia or regional anesthesia (spinal or epidural anesthesia) is important and based on many indications, including how urgent delivery should be and the medical and obstetric history of women. Regional anesthesia is almost always safer for women and infants but sometimes general anesthesia is safer for one or both, and the classification of the urgency of labor is an important issue affecting this decision.
Pre-planned caesarean section (or elective/scheduled cesarean section), prescribed, is most often prescribed for medical indications developed before or during pregnancy, and ideally after 39 weeks of pregnancy. In the UK, these are classified as 'grade 4' sections (the delivery time is matched with the mother or hospital staff) or as part of 'grade 3' (no maternal or fetal compromise but early labor required). Emergency caesarean section is performed in pregnancy where vaginal delivery is planned initially, but indications for cesarean delivery have been developed since then. In the UK they are further classified as class 2 (required delivery within 90 minutes of the decision but no direct threat to the life of the woman or fetus) or level 1 (delivery is required within 30 minutes of the decision: direct threat to the mother or baby's life or both.)
An elective Caesarean section may be performed on the basis of a medical or medicinal indication, or because of a maternal request that is not medically indicated. Among women in the UK, Sweden and Australia, about 7% of elective caesareanes are the method of delivery. In cases without medical indication, the Congress of Obstetricians and Gynecologists of America and the Royal College of Obstetricians and Gynecologists of the United Kingdom recommended the delivery of the planned vagina. The National Institute for Health and Nursing Excellence recommends that if after a woman has provided information about the risk of a planned caesarean section and she still insists on the procedure that should be provided. If given this should be done at 39 weeks or later.
With mother characteristics
Cesarean delivery at mother's request
Cesarean delivery at the request of the mother (CDMR) is a medically unnecessary caesarean section, where the delivery of labor by caesarean section is requested by the pregnant patient even though there is no medical indication to undergo surgery.
After previous caesarean section
Mothers who had previously had a cesarean section were more likely to have a caesarean section for future pregnancies than women who had never had a cesarean section. There is a discussion of the circumstances in which women should give birth normally after a previous cesarean section.
Vaginal delivery after caesarean section (VBAC) is the practice of giving birth to a baby through the vagina after the previous baby is delivered by caesarean section (surgery). According to the American College of Obstetricians and Gynecologists (ACOG), the success of VBAC is associated with decreased maternal morbidity and reduced risk of complications in subsequent pregnancies. According to the American Pregnancy Association, 90% of women who underwent cesarean section were candidates for VBAC. Approximately 60-80% of women who choose VBAC will succeed in giving birth normally, which is proportional to the overall rate of vaginal delivery in the United States in 2010.
Twins
For healthy twin pregnancies, where both twins will undergo vaginal birth examination is recommended between 37 and 38 weeks. The vaginal delivery in this case does not worsen the outcome for the baby either compared to a caesarean section. There is controversy about the best delivery method in which the first twin is the first head and the second does not. When the first twin does not point down at the start of labor, a cesarean section should be recommended. Although the second twin typically has a higher frequency of problems, it is not known whether the planned caesarean section affects this. An estimated 75% of twin pregnancies in the United States were born by caesarean section in 2008.
Breech birth
Breech birth is the birth of a baby from a butt presentation, in which the baby comes out of the pelvis with the butt or first leg as opposed to a normal first-head presentation. In a breech presentation, the sound of the fetal heart sounds just above the umbilicus.
Bottom positions present some harm to infants during birth, and the mode of delivery (vagina versus cesarean) is controversial in the area of ​​midwifery and midwifery.
Although normal birth is possible for breech babies, certain fetal and maternal factors affect the safety of vaginal breech births. Most breech babies born in the United States and Britain are delivered by caesarean section because studies have shown an increased risk of morbidity and mortality for vaginal breech birth, and most obstetricians advise on the birth of the vaginal breech that is planned for this reason. As a result of the reduced number of genuine vaginal breech births, obstetricians and midwives are at risk of de-skilling in this important skill. All involved in the delivery of midwifery and midwifery care in the UK underwent mandatory training in delivery of breech in a simulated environment (using dummy pelvises and mannequins to enable this essential skill practice) and this training is conducted regularly to keep skills up to date.
Resusitative Hysterectomy
A resuscitation hysterotomy, also known as cesarean delivery of peri-mortem, is an emergency cesarean delivery performed where maternal cardiac arrest has occurred, to assist maternal resuscitation by removing the aortocaval compression produced by the gravid uterus. Unlike other forms of caesarean section, fetal wellbeing is a secondary priority, and the procedure can be performed even before the fetal viability limit if it is considered beneficial to the mother.
Other ways, including with operating techniques
There are several types of Caesarean section (CS). The important difference lies in the type of incision (elongated or transverse) made on the uterus, apart from the incision on the skin: most of the skin incision is a transverse approach suprapubic known as the Pfannenstiel incision but there is no way of knowing from the skin scar where the uterine incision is performed.
- The classic caesarean section involves a midline incision on an elongated incision allowing a larger space to give birth to a baby. This is done in very early pregnancies where the lower uterine segment is not formed because it is safer in this situation for infants: but rarely performed other than in this early pregnancy, as surgery is more susceptible to complications than low. a transverse uterine incision. Any woman who has had a classic section would be recommended to have an elective repeating section in subsequent pregnancies because vertical incisions are much more likely to break out in labor than a transverse incision.
- The lower uterine segment is the most commonly used procedure today; it involves cross-cuts just above the edge of the bladder. It produces less blood loss and has fewer early and late complications for the mother, and allows her to consider vaginal birth in subsequent pregnancies.
- The cesarean hysterectomy consists of a caesarean section followed by removal of the uterus. This can be done in cases of difficult bleeding or when the placenta can not be separated from the uterus.
The EXIT procedure is a special surgical delivery procedure used to deliver a baby with airway compression.
The Misgav Ladach method is a modified caesarean operation that has been used almost all over the world since the 1990s. It was described by Michael Stark, president of the New European Surgical Academy, at the time he was the director of Misgav Ladach, the public hospital in Jerusalem. This method was presented during the FIGO conference in MontrÃÆ'Ã… © al in 1994 and later distributed by the University of Uppsala, Sweden, in over 100 countries. This method is based on minimalist principles. He examines all the steps in a caesarean section, analyzes it for their needs and, if necessary, for their optimal performance. For an abdominal incision he uses a modified incision of Joel Cohen and compares the longitudinal abdominal structure with a string on the instrument. Because the blood vessels and muscles swing laterally, it is possible to stretch rather than cut them off. The peritoneum is opened by repeated stretching, no abdominal swab is used, the uterus is covered in a layer with a large needle to reduce the amount of foreign matter as much as possible, the peritoneal layer remains unabsorbed and the stomach is covered with two layers only. Women who undergo this surgery recover quickly and can care for newborns shortly after surgery. There are many publications that show advantages over traditional caesarean methods. However, there is an increased risk of abruptio placentae and uterine rupture in subsequent pregnancies for women who underwent this method in previous deliveries.
Technique
Prophylactic antibiotics are used before the incision. The uterus is sliced, and the incision is extended with a blunt pressure along the cephalad-caudad axis. The baby is born, and the placenta is then removed. The surgeon then makes a decision about the uterine exteriorization. A one-layer uterine cover is used when the mother does not want a future pregnancy. When the subcutaneous tissue is 2 cm or more, surgical sutures are used. Unsolicited practices include manual cervical dilatation, subcutaneous drain, or additional oxygen therapy in order to prevent infection.
Caesarean section can be performed with single or double layer stitches of the uterine incision. Closure of a single layer compared to a double layer closure has been observed to result in reduction of blood loss during surgery. It is uncertain whether this is a direct effect of the sewing technique or if other factors such as the type and location of the abdominal incision contribute to reducing blood loss. Standard procedures include the closure of the peritoneum. However, the question of this study may not be necessary, with some studies suggesting closure of the peritoneum is associated with longer surgery time and hospital stay. The Misgave Ladach method is a surgical technique that may have fewer secondary complications and faster healing, due to insertion into muscles.
In many hospitals, mothers partners are encouraged to attend operations to support mothers and share experiences. An anesthesiologist will usually decrease a temporary hang-up when a child is born so that parents can see their newborn baby.
Anesthesia
General and regional anesthesia (spinal, epidural or a combination of spinal and epidural anesthesia) may be acceptable for use during caesarean section. The evidence shows no difference between regional anesthesia and general anesthesia with respect to primary outcome in the mother or infant. Regional anesthesia may be preferred because it allows the mother to wake up and interact immediately with her baby. Compared with general anesthesia, regional anesthesia is better at preventing persistent postoperative pain 3 to 8 months after cesarean section. Other advantages of regional anesthesia may include the absence of typical risks of general anesthesia: lung aspiration (which has a relatively high incidence in patients undergoing anesthesia in late pregnancy) gastric contents and esophageal intubation. However, one trial found no difference in satisfaction when general anesthesia was compared with spinal anesthesia.
Regional anesthesia is used in 95% of delivery, with spinal and spinal epidural anesthesia and a combination is the most commonly used regional technique in the scheduled caesar section. Regional anesthesia during cesarean section differs from analgesia (pain relief) used in labor and vaginal delivery. The pain experienced by surgery is greater than labor and therefore requires a more intense neural block.
General anesthesia may be necessary because of special risks for the mother or child. Patients with uncontrolled heavy bleeding can not tolerate the regional hemodynamic effects of anesthesia. General anesthesia is also favored in very urgent cases, such as severe fetal pressure, when there is no time for regional anesthesia.
Prevention of complications
Postpartum infections are one of the leading causes of maternal death and can cause 10% of maternal deaths globally. Caesarean section greatly increases the risk of infection and associated morbidity (estimated between 5 and 20 times higher), and routine use of prophylactic antibiotics to prevent infection is recommended. Infection can occur in about 8% of women who undergo caesarean section, most endometritis, urinary tract infection and wound infection. Use of preventive antibiotics in women undergoing cesarean section reduced wound infections, endometritis, and serious infectious complications by about 65%. Side effects and effects on infants are unclear.
Women who undergo caesarean section can recognize signs of fever that indicate the possibility of wound infection. Taking antibiotics before skin slices rather than after clamping the cord reduces the risk for the mother, without increasing the adverse effects for the baby. Whether a certain type of skin cleanser improves the results is not clear.
Some doctors believe that during a caesarean section, mechanical cervical dilatation with the fingers or forceps will prevent blood obstruction and lochia drainage, and thus benefit the mother by reducing the risk of death. The available clinical evidence is insufficient to draw conclusions about the effects of this practice.
Recovery
It is common for women who undergo caesarean section to reduce or absent bowel movements for hours to days. During this time, the woman may experience abdominal cramps, nausea and vomiting. It usually goes away without treatment. Stomach pain, injury and back may continue for months after cesarean section. Non-steroidal anti-inflammatory drugs may be helpful. Women who undergo caesarean section are more likely to experience pain that interferes with their usual activity than women who give birth to the vagina, although six months is usually no difference. However, pain during intercourse is less likely than after vaginal birth, although again, six months there is no difference.
There may be a somewhat higher incidence of postnatal depression in the first few weeks after delivery for women who undergo cesarean section, but this difference does not continue. Some women who undergo caesarean section, especially emergency caesar, experience post-traumatic stress disorder.
Usage
In Italy, the incidence of cesarean section is very high, although it varies from region to region. In Campania, 60% of births in 2008 are reported to occur by caesarean section. In the Rome area, the average incidence is around 44%, but can reach as high as 85% in some private clinics.
With nearly 1.3 million overnight stay, caesarean section is one of the most common procedures performed in US hospitals in 2011. This is the second most common procedure performed for people ages 18 to 44. The caesarean section in the US has increased rapidly since 1996. This procedure increased by 60% from 1996 to 2009. In 2010, the caesarean birth rate was 32.8% of all deliveries (a slight decrease from 2009's highest 32.9% of all deliveries). A study found that in 2011, women covered by private insurance were 11% more likely to deliver by cesarean than those covered by Medicaid.
China has been called to have the highest C-section rate in the world at 46% in 2008.
Studies have shown that continuity of care with known caregivers can significantly reduce caesarean delivery rates but there are also studies that seem to show that there is no significant difference in cesarean rates when comparing sustainability care of midwives with conventional fragmented treatments.
More emergency caesarean sections - about 66% - performed during the day rather than at night.
This number has risen to 46% in China and to 25% and higher in many Asian, European and Latin American countries. This figure has risen in the United States, to 33% of all births in 2012, up from 21% in 1996. Across Europe, there are differences between countries: in Italy, the caesarean section rate is 40%, while in the country - the Nordic country is 14%. In Brazil and Iran, the caesarean section rates more than 40%.
Increase usage
In the United States, the C-section rate has increased from more than 20% in 1996 to 33% in 2011. This increase does not result in improved results that result in the C-section position being carried out too often.
The World Health Organization formally withdrew its previous recommendation of a 15% C-section rate in June 2010. Their official statement reads, "There is no empirical evidence for optimal percentage, the most important being that all women who require a caesarean section receive it."
Speculation explains the relationship between birth weight and mother's pelvic size has been proposed. The explanation, based on Darwin-inspired logic, suggests that since the birth of a successful caesarean birth, more mothers with small pelvis and babies with large birth weight survive. This hypothesis will predict the increase in mean birth weight, which has been observed. It is unclear what component contributes more to this effect; evolution or environment.
Brazil is one of the world's highest cesarean rates with rates in the public sector averaging 35-45% while private sector rates are as high as 80-90%.
Epidemiology
The global level of Caesarean section increases. In the UK, in 2008, the cesarean section rate was 24%. In Ireland, the rate was 26.1% in 2009. The Canadian rate was 26% in 2005-2006. Australia has a high caesarean section rate, at 31% in 2007. In the United States the rate of caesarean section is about 33% and varies from 23% to 40% depending on the country in question. One in three women who gave birth in the US gave birth by caesarean section in 2011. By 2012, nearly 23 million C-section is done globally. At one time the 10% and 15% levels were considered ideal. A higher rate of 19% can yield better results. More than 50 countries have rates of more than 27%. 45 other countries have a rate of less than 7.5%. There are efforts to improve access and reduce the use of C-section. In the United States about 33% of deliveries are made by caesarean section. Rates in the UK and Australia were 26.5% and 32.3%, respectively. In China, the latest CS rate reported was 41%. Globally, 1% of all caesarean births are performed without medical needs for one. Overall, the rate of caesarean section rate was 25.7% during 2004-2008.
Wound infections occur after cesarean section at the level of 3-15%. Some women are at greater risk for developing a surgical site infection after childbirth. The presence of chorioamnionitis and obesity affects women to develop surgical site infections.
History
The mother of Bindusara (born in 320 BC, reigning 298 - c 272 BC), Mauryan's second [Samrat] (emperor) from India, accidentally consumed poison and died when she almost gave birth. Chanakya, teacher and adviser Chandragupta, decided that the baby should survive. She cut the queen's stomach and took out the baby, saving the baby's life.
According to the ancient Chinese Record of the Grand Liter, Luzhong, the sixth generation of the Yellow Emperor, has six sons, all born with "cutting bodies". The sixth son of Jilian founded the Mi House that governed Chu State (ca. 1030-223 BC).
In the Irish mythology text, the Ulster Cycle, the character Furbaide Ferbend is said to be born by a posthumous after posthumous operation, after his mother was killed by Medb's evil aunt.
Babylonian Talmud, an ancient Jewish religious text, mentions a procedure similar to a cesarean section. This procedure is called yotzei dofen . It also discusses the length of permissibility of c-section in the mother who is dying or dead.
Pliny the Elder theorizes that the name of Julius Caesar comes from an ancestor born by caesarean section, but this truth is disputed (see discussion on Caesar etymology). Ancient Roman Caesarean section was first performed to remove the baby from the womb of a mother who died in childbirth. Julius Caesar's mother, Aurelia, lived through labor and succeeded in giving birth to her son, setting aside the possibility of Roman rulers and generals being born by cesarean section. His first wife, however, died in childbirth, giving birth to a severed son who may have undergone a cesarean section.
The Catalan saint Raymond Nonnatus (1204-1240), received the surname - from Latin non-natus ("not born") - because he was born by caesarean section. Her mother died in childbirth.
A preliminary report on cesarean sections in Iran is mentioned in Shahnameh's book, written around 1000 CE, and is associated with the birth of Rostam, Iran's national legendary hero. According to Shahnameh, Simurgh instructed Zal on how to perform a cesarean section, thus saving Rudaba and Rostam's son.
Cesareans usually result in maternal death. In a report from the 1580s, in Siegershausen, Switzerland, Jakob Nufer, a pig gelder, was supposed to carry out an operation on his wife after a long labor, with him still alive. However, there are also some grounds to assume that Jewish women regularly survived surgery in Roman times. For most of the time since the 16th century, this procedure has a high mortality rate. However, it has long been considered an extreme measure, done only when the mother is dead or considered to be helpless. In England and Ireland, the mortality rate in 1865 was 85%. The key steps in reducing mortality are:
- The introduction of the transverse incision technique to minimize bleeding by Ferdinand Adolf Kehrer in 1881 was considered the first modern CS performed.
- Introduction of uterine stitches by Max SÃÆ'¤nger in 1882
- Modified by Hermann Johannes Pfannenstiel in 1900, see Pfannenstiel incision
- CS extraperitoneal and then moved to a low transverse incision (KrÃÆ'¶nig, 1912)
- Compliance with the principle of asepsis
- Anesthesia Progress
- Blood transfusion
- Antibiotics
European tourists in the Great Lakes region of Africa during the 19th century observed a regular caesarean section. Pregnant women are usually anesthetized with alcohol, and herbal mixtures are used to promote healing. From well-developed procedures of the procedures used, European observers concluded that they had been employed for some time. James Barry performed the first successful cesarean surgery by a European doctor in Africa in Cape Town, when he was stationed there between 1817 and 1828.
The first successful caesarean performed in the United States took place in Mason County, Virginia (now Mason County, West Virginia), in 1794. Jesse Bennett to his wife, Elizabeth.
On March 5, 2000, in Mexico, InÃÆ'® s RamÃÆ'rere performed a caesarean section on himself and survived, as did his son, Orlando Ruiz RamÃÆ'rerez.
Caesarius from Terracina
Caesarius Caesarius Caesarean armor of Africa, a young deacon martyred in Terracina, who had succeeded and converted the Emperor's kafir. Martyrs (Saint Cesareo in Italy) are called to the success of this surgical procedure.
Society and culture
Etymology
The Roman Lexia (royal law), then Lex Caesarea (imperial law), Numa Pompilius (715-673 BC), requires the child of a mother who died in labor for cut from his womb. There is a cultural taboo that mothers are not buried pregnant, which may reflect how to save some fetuses. Roman practice requires a living mother to be on her tenth month of pregnancy before switching to a procedure, reflecting the knowledge that she can not survive labor. Speculation that the Roman dictator, Julius Caesar, was born with a method now known as the C-section seems wrong. Although cesareans were performed in Roman times, there is no classic source that records a mother who survived such a birth. Until the 12th century, scholar and physician Maimonides expressed doubts over the possibility of a woman surviving this procedure and getting pregnant again. This term has also been described as derived from the verb caedere , "to cut", with children delivered in this way referred to as caesones . Pliny the Elder refers to certain Julius Caesar (the ancestor of the famous Roman statesman) as ab utero caeso, "cut from the womb" giving this as an explanation for the cognomen "Caesar" which was later brought on by his descendants. Nevertheless, even if the etymological hypothesis linking Caesarean surgery with Julius Caesar is the wrong etymology, it has been widely believed. For example, the Oxford English Dictionary defines the birth of a caesar as "sending a child by cutting the abdominal wall when delivery can not be done in a natural way, as in the case of Julius Caesar".
Some relationships with Julius Caesar or with Roman emperors exist in other languages ​​as well. For example, modern German, Norwegian, Danish, Dutch, Swedish, Turkish and Hungarian terms are respectively Kaiserschnitt , keisersnitt , kejsersnit , < i> keizersnede , kejsarsnitt , sezaryen and csÃÆ'¡szÃÆ'¡rmetszÃÆ' Â © s (literally: "emperor cut"). The German term has also been imported into Japanese (???? tei> Sekkai ) and Korean (???
According to Shahnameh's ancient Persian book, Rostam's hero was the first person born with this method and the term ??????? ( rostamineh ) is associated with a caesarean. Also, the monkey god of Hindu mythology Hanuman was born through a similar procedure to his mother Anjani.
Finally, Roman praenomen (named) Caeso is said to be given to children born through C-section. Although this may be just a folk etymology popularized by Pliny the Elder, it is already known when the term becomes publicly used.
Spelling
The term caesarean is spelled in various accepted ways, as discussed in Wiktionary. The Medical Subject Headings (MeSH) of the National Library of Medicine (NLM) of the United States uses cesarean section , while some other American medical works, eg. Saunders Comprehensive Veterinary Dictionary , use caesarean , like most English works. The online version of Merriam-Webster's dictionary and American Heritage Dictionary lists first cesarean and other spellings as "variants", etymologically historical position.
Custom case
In Judaism, there is a dispute between the postcolon (Rabbinic authorities) about whether the first son born of a caesarean has a law of bechor. Traditionally, a boy sent through Caesarea did not qualify for the dedication ritual of Pidyon HaBen.
In rare cases, a caesarean can be used to remove a dead fetus. A late-stage abortion using a cesarean section procedure is called a hysterotomy abortion and is very rare.
A self-administered caesarean is one performed by the mother alone. There appeared to be several successful cases, notably InÃÆ'Â Â © s RamÃÆ'rerez PÃÆ' Â © rez of Mexico who in March 2000, performed a successful caesarean on himself.
References
Source of the article : Wikipedia
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