Current Concepts Review on Caesarean Section and Guidelines for Safe Surgical Techniques

Abstract

Caesarean  Section (CS), also known as Caesarean Delivery (CD) or C-section  is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen and uterus often performed because vaginal delivery would put the baby and or the mother at risk. CS  has been part of human culture since ancient times and there are tales in both western and non-western cultures of this procedure. The rise in the rates of CS partly as a result of better surgical techniques and availability of blood transfusion and antibiotics and partly because of social factors such as fear of litigation should there be any fetal or maternal morbidity and woman aspiration to have a healthy baby. CS is the ultimate method of successful delivery of infants under various circumstances and is an indispensable operation in obstetrics. However, the degree of difficulty varies greatly depending on the gestational age of pregnancy, number  of foetuses, number of previous CS, presence of uterine myomas, maternal obesity and other factors. In addition, emergency CS is a battle against time and prompt surgery is required. Caesarean section rates have increased globally and bleeding associated with CS is the most common cause of haemorrhage related maternal death. There are global efforts to reduce maternal morbidity and mortality. As with most surgical procedures, there is no standard technique for CS. In view of the importance of this life saving surgical procedures, we carried out a narrative review on the historical perspective, epidemiology, classification, types, indications, surgical techniques, complications and safety measures to reduce complications during CD.