Caesarean section is one of the commonly performed surgical procedures in obstetric and is certainly one of 1 the oldest operations in surgery. There are two types of Caesarean section (CS). An important distinction lies in the type of incision made in the uterus, apart from the incision on the skin. According to the type of incision, these two types include the classical Caesarean section (CS) and lower uterine segment cesarian section (LSCS). The lower uterine segment section is the procedure most commonly used today; it involves a transverse cut just above the edge of the bladder and results in less blood loss and is easier to repair. It may be transverse (the usual) or vertical in the different conditions that involves the presence of lateral varicosities,constriction ring to cut through it and deeply engaged head
Over the last century delivery by caesarean section has become increasingly safer, but it cannot replace vaginal delivery in terms of low maternal and neonatal 4 morbidity and less cost.Possible indications of LSCS include:
- Cephalopelvic disproportion (use of pelvimetry is not advised).
- Multiple pregnancy.
- Severe hypertensive disease in pregnancy.
- Fetal conditions: distress, iso-immunisation, very low birth weight.
- Failed induction of labour.
- Repeat caesarean section.
- Pelvic cyst or fibroid.
- Maternal infection (eg, herpes, HIV)
If you are pregnant with twins, there’s a good chance you could have a c-section birth. You might even have one planned in advance. But even if you plan to have a vaginal birth (which is very common with twins) you never know what might happen. It’s always good to be prepared.
The incidence of twins varies considerably between communities and families and has recently increased because of the number of older mothers and the use of fertility treatments and assisted conception. Twin pregnancies are at increased risk of intrapartum complications, such as fetal heart rate abnormalities and complications related to malpresentation than infants from a singleton pregnancy. The optimal route of delivery for the twin gestation is not known. While vaginal delivery is common when both twins are vertex and of similar size, cesarean delivery is typically performed when the first twin is breech and in many cases when the first twin is vertex and the second is malpositioned. Cesarean is resorted to in these cases out of concern for the morbidity that, in some, but not all studies have been associated with the second twin that includes birth trauma due to increased manipulation during delivery, cord prolapse, premature placental separation, and a prolonged second stage for the second twin as compared to the first.
Planned caesarean section may reduce the risk of: perineal and abdominal pain during birth; Injury to vagina; early postpartum haemorrhage and obstetric shock.
It is possible that some of the adverse outcomes may be avoided by appropriately timed delivery by caesarean section, but the risks of caesarean section for the mother in the current and subsequent pregnancies must be taken into account. Cesarean section is, however, associated with increased risks to both mother and child. It should only be performed when it is clearly advantageous.