A caesarean section is performed when the birth process naturally impossible or dangerous for the life of the mother and fetus. IN modern conditions Caesarean sections are performed quite often. Thus, in Moscow, about 15% of all births are carried out through this operation, which indicates a decrease in the number of physiological pregnancies and births.

As is typical for any surgical intervention, there are certain indications for cesarean section. They can be absolute and relative in nature, they can develop both on the part of the fetus ( possible danger hypoxia or birth trauma) and from the mother (direct threat to the woman’s health during the birth process). Reasons for implementation caesarean section may occur during pregnancy and childbirth.

Indications for caesarean section related to the course of pregnancy

• deformation bony pelvis and tumors that can create obstacles during the passage of the fetus through the birth canal;
• placenta previa. With this pathology, the placenta is attached to the wall of the uterus in its lower segment, as a result of which it partially or completely blocks its internal os (the entrance to the uterine cavity from the vagina). The most common and formidable complication This condition is life-threatening bleeding for the woman in labor and the baby. Caesarean section for placenta previa is performed at 38 weeks of gestation, and if bloody issues occur earlier, then surgical intervention is performed immediately;
• premature placental abruption with normal location. In a physiological course, the placenta exfoliates in the third stage of labor, which occurs after the birth of the child. In some cases, this may occur earlier than expected, resulting in profuse bleeding that threatens the life of the woman and fetus;
• incompetent scar on the uterus after previous previous surgical interventions. Scar failure is diagnosed if, according to ultrasonographic examination, its thickness is less than 3 mm, there is connective tissue in its structure, and the contours of the scar are uneven. Also, signs of insolvency include complicated postoperative period after previous cesarean sections (pronounced temperature reaction of the body, various inflammatory processes in the uterus, long and slow healing of skin sutures);
• two or more scars on the uterus as a result of cesarean sections. Experts say that managing childbirth in a natural way in this condition leads to increased risk uterine rupture along the scar, so the operation is performed before the onset of labor;
• II-IV degree of anatomically narrow pelvis. Diagnosed during pregnancy by determining the linear dimensions of the pelvis. Obstetricians are guided by specific criteria normal sizes bone pelvis and different degrees narrowing;
• condition after plastic surgery of the cervix, vagina, entero-genital and genitourinary fistulous tracts. Fistulas are an unnatural communication between two hollow organs;
• malformations of the internal female genital organs;
• good and malignant neoplasms uterus, ovaries and other structures of the pelvic cavity that create an obstacle along the birth canal;
• large fetus (weight 4 kg or more), combined with another pathology;
• pronounced discrepancy pubic bones, in which there arise painful sensations and difficulty walking (symphysitis);
• multiple myomatous nodes of the uterus, disruption of their blood supply;
• late gestosis with a severe or complicated course, not amenable to conservative treatment. This includes mainly pre-eclampsia and eclampsia, accompanied by disturbances in the functioning of the circulatory system and the central nervous system;
• severe extragenital pathology: decompensated diseases of the circulatory system, diabetes, myopia with pronounced pathological changes fundus vessels, pathology nervous system;
• scar structures (narrowings) of the vagina and cervix, which can occur as a result of previous childbirth or operations, make it impossible to dilate the cervix and reduce the elasticity of the vaginal walls;
• previous perineal rupture III degree(damage to the sphincter of the anus and/or the mucous membrane of the rectum, insufficient suturing of which can subsequently lead to incontinence of feces and gases);
• visual visible expansion of the vaginal veins, which during natural birth may be complicated by life-threatening bleeding;
• transverse position of the fetus in the uterus;
• pregnancy Siamese twins(conjoined twins);
• fetal weight less than 1500 g or more than 3600 g in combination with breech presentation and pelvic contraction. Under such conditions, the risk of injury to the fetal head when passing through the birth canal increases significantly;
• artificial and in vitro fertilization subject to availability additional complications from the side of the fetus or the woman in labor;
• fetal malnutrition, its chronic hypoxia, in which there is low effectiveness of conservative treatment;
• a primigravida woman over 30 years of age or a history of long-term infertility in combination with concomitant pathology;
• hemolytic disease of the fetus in combination with an unprepared birth canal. In case of isoantigenic incompatibility of the blood of mother and fetus according to the Rh factor or group, massive destruction of fetal erythrocytes, hypoxia and intoxication syndrome occurs;
• post-term pregnancy or diabetes mellitus with unprepared birth canal or combination with additional pathology;
• malignant tumors of any location;
• genital herpes in the acute stage (the presence of vesicular rashes on the surface of the external genitalia).

Indications for caesarean section related to the course of labor

• clinically narrow pelvis(any discrepancy between the linear dimensions of the mother’s bone pelvis and the fetal head);
• untimely (early) discharge of amniotic fluid, ineffectiveness medicinal methods induction of labor (use of oxytocin, prostaglandin drugs);
• abnormalities of labor (weak or discoordinated sexual activity) with failure of conservative treatment;
• hypoxic conditions of the fetus with an acute course. Cardinal symptom of development this complication is a sharp decline fetal heart rate, which does not recover after a certain period of time;
• detachment of a normally or low-attached placenta. It happens that the placenta exfoliates not in the III, but in the II phase of labor (the period of expulsion). This phenomenon is accompanied by profuse bleeding, requiring urgent surgical intervention;
• threat of uterine rupture or its onset. Of particular importance here is timely diagnosis this condition and correctly chosen medical tactics;
• presentation of umbilical cord loops or their prolapse. As a result of pinched umbilical cord in combination with cephalic presentation of the fetus, in the absence of surgery, the child may die within a few minutes;
• incorrect insertion of the presenting part. In the case of cephalic presentation, this applies to extension presentations (facial and frontal), and also includes a high, straight position of the head.

In some complex clinical situations, a cesarean section is performed for combined indications, when individual pathological conditions in themselves are not a sufficient reason to perform this surgical intervention, but in their totality, complications of pregnancy and the birth process create a background of increased threat to the life of the child or woman.

Video: Indications for childbirth by caesarean section.

ABOUT possible harm a lot has been said about the drugs that are used during a cesarean section, as well as about the consequences of neglecting the need for the child to pass through the birth canal. But some mothers still think that it is easier to “give birth” on the operating table, thanks to the incision made by the doctor in the abdominal wall. Only a few go to the doctor to ask for a CS. Meanwhile, there are clear indications for caesarean section in official list 2018.

In the CIS countries, which includes Russia, Ukraine, and Belarus, there are unified medical protocols that clearly define absolute and relative indications for prescribing a caesarean section. In most cases, they refer to situations where natural childbirth poses a threat to the health and life of the mother and fetus.

If a doctor recommends a CS, you cannot refuse it, because, as they say, all the rules are written in blood. There are states in which the mother herself decides how to give birth. This happens, for example, in England. We do not have such a practice, however, as well as laws prohibiting a woman from going under the knife without clear evidence.

Moreover, all these indications are conditionally divided into 2 groups:

• Absolute - they are not discussed, since if they are detected, the doctor simply prescribes the day and time of the operation. Ignoring his recommendations can cause serious harm to the body of the mother and baby, even death.
• Relative. There are cases in which natural childbirth is still possible, although it can also be harmful. What to do with relative indications is decided not by the woman, but by a council of doctors. They weigh the pros and cons, making sure to explain the possible consequences to the expectant mother, and then come to a common decision.

And that is not all. There are unplanned situations in which other factors are identified during pregnancy or during childbirth, on the basis of which surgery may be prescribed.

Absolute maternal and fetal indications

• Placenta previa. The placenta is a child's place. The diagnosis is made when it blocks the entrance to the uterus from the vagina. During childbirth, this condition threatens severe bleeding, so doctors wait until 38 weeks and prescribe surgery. They may operate earlier if bleeding begins.
• Her premature detachment. Normally, everything should happen after the baby is delivered, but it also happens that detachment begins during pregnancy. Due to the fact that everything ends in bleeding, which threatens the life and health of both, an operation is performed.
• An irregular scar on the uterus, which is the result of another operation in the past. An incorrect one is understood as one whose thickness does not exceed 3 mm, and whose edges are uneven with inclusions connective tissue. The data is determined by ultrasound. Caesarean sections with a scar are also not permitted in cases where, during its healing, there was an increase in temperature, inflammation of the uterus, and the suture on the skin took a long time to heal.
• Two or more scars on the uterus. It is worth noting that not all women decide to have a natural birth after a cesarean section due to fear of scar dehiscence. Doctors can explain the pros and cons of the procedure, but nothing more. There is an order from the Ministry of Health, according to which a woman can write a refusal of ER in favor of a cesarean section even with a normal scar, and she will have to undergo surgery. True, the question of EP is not even raised if there were several scars. Even before labor begins, the woman is simply operated on.
• Anatomical narrowing of the pelvic bone to 3 – 4 degrees. The doctor takes the measurements. In such conditions, water may break in advance, contractions will weaken, fistulas will form or tissue will die, and finally, the baby may develop hypoxia.
• Deformations pelvic bones or tumors - they can prevent the baby from entering the world peacefully.
• Malformations of the vagina or uterus. If there are tumors in the pelvic area that close the birth canal, surgery is performed.
• Multiple uterine fibroids.
• Severe gestosis, untreatable and accompanied by convulsive seizures. The disease entails disruption of the functions of vital organs and systems, in particular the cardiovascular and nervous systems, which can affect both the condition of the mother and the condition of the baby. If doctors fail to act, death occurs.
• Cicatricial narrowing of the uterus and vagina that appeared as a result of previous births and surgical interventions. In such conditions, stretching the walls to allow the child to pass through threatens the life of the mother.
• Severe heart disease, nervous system disease, diabetes mellitus, thyroid problems, myopia with changes in the fundus of the eye, hypertension (it can affect vision).
• Genitourinary and enterogenital fistulas, sutures after plastic surgery on the vagina.
• History of 3rd degree perineal rupture (sphincter and rectal mucosa are damaged). They are difficult to suture, and it can also end in fecal incontinence.
• Breech presentation. In this condition, the risk of getting birth injuries, including head injury.
• Transverse position of the fetus. Normally, the baby should lie head down immediately before birth. There are times when he turns several times, especially for small children. By the way, it is not recommended to give birth on your own, even for low birth weight babies (weighing less than 1,500 kg). Do you know why? It turns out that under such conditions, passage through the birth canal can compress the head or testicles (in boys), which will lead to the development of infertility.
  
• Indication by age. Late pregnancy in primigravidas in combination with other pathologies. The fact is that after 30 years in women, the elasticity of the vaginal muscles deteriorates, resulting in severe tears.
• Death of a mother in labor. If for some reason a woman’s life cannot be saved, doctors fight for her baby. It has been proven that he is able to remain alive for several hours after death. During this time the operation should be performed.
• Threatening uterine rupture. Its causes can be either numerous previous births, which have thinned the walls of the uterus, or a large fetus.

Dear mothers! You should not regard absolute medical indications for a caesarean section as a death sentence, much less be angry with the doctor. These are simply the prevailing circumstances that leave him no choice.

Relative indications from mother and fetus

There are situations when, when making a decision, doctors consult with the woman. Interestingly, in 80% of cases, they agree to surgery unconditionally. And this is not just a matter of worry about the child, although this also plays a vital role.

Mothers weigh the pros and cons, taking into account the qualifications of modern surgeons, the quality suture material Finally, the conditions for conducting operations and consciously try to reduce any risks to nothing.

List of relative indications for CS:

There are situations when a woman going for a natural birth still ends up on the operating table. This happens if problems arise during the process itself.

Indications for emergency caesarean section

The decision to operate is made in the active stage of labor when:

• Absence of labor (if after 16 - 18 hours the cervix slowly opens).
• Umbilical cord prolapse. It can shrink, which will impede the flow of oxygen to the baby.
• When hypoxia is detected. In such conditions, the child may suffocate during contractions.

An emergency caesarean section can also be performed in other cases that pose a threat to the life and health of the woman in labor and her baby.

Note! Umbilical cord entanglement is not a clear indication for CS, although doctors may offer this method to a woman in labor. It all depends on the length of the umbilical cord itself, and the type of entanglement (tight, loose, single, double).

A cesarean section has not only disadvantages, but also...

Is caesarean section performed without indication?

Because a caesarean section is a major operation with enormous risks to the mother's health, it is never performed voluntarily. Neither fear, nor tears, nor hemorrhoids that worsened on the eve of childbirth will help a woman dissuade doctors.

Everything will pass, and this too will pass. The main thing is to pull yourself together and give birth. After all, there is no turning back!

Any woman who is carrying a baby worries about his birth. Many of them have indications for caesarean section during pregnancy. Some people are notified about this in advance. Others are committed to natural childbirth, but if problems arise, a surgical outcome is also possible, as the only correct solution. This operation is never simply prescribed by the responsible gynecologist and always has a justification. Traditionally, there are different types of planned and emergency interventions. Let's look at them.

The list of reasons is quite extensive and is aimed at carrying out the birth of a child according to the planned schedule, or preventing a critical situation. From conversations with doctors, it is known that there are women in labor who turn to them with a request to do mechanical impact without medical advice. Some choose it because they are terrified of pain. Others find it convenient to deceive nature and choose a birthday of their own choosing. Still others are afraid of breaking up and acquiring a sexual disorder.

The question arises, is it safe for the baby? An accurate answer requires careful monitoring of mommy and baby. To make a final decision, you need to soberly assess all the circumstances as a whole.

Based on medicine, the list of indications for caesarean section is divided into two types.

Absolute indicators from the parturient woman

1. Narrow pelvis– he will not allow a woman to give birth on her own. Narrowing is differentiated by degree. A planned cesarean section is performed at 3–4 tbsp. Second Art. indicates that a decision has been made regarding the course of labor.

The dimensions of the pelvis are normal or the first stage. indicate the possibility of natural delivery. But if the fetus grows large, it is possible that it will become clinically narrow. The pelvic ring is then smaller in comparison with the fetal head.

The correct measurement can be made using an ultrasound examination or an x-ray.

There are times when it has a normal volume, but the baby turns. When a vaginal examination reveals insertion of the head with the face or forehead, then spontaneous childbirth is unacceptable. Because it acquires the largest dimensions. This position will cause an emergency caesarean section (CS).

2. Mechanical difficulties identified by ultrasound. Examples include deformation of the pelvic bones, neoplasms in the ovaries, and uterine fibroids in the isthmus.

3. The danger of uterine rupture for women who have previously undergone a CS or some kind of surgery on female organ. The doctor determines this probability by the presence of a scar. Having a thickness of less than three millimeters, uneven contours, inclusions of connective tissue will be dangerous because it will tear along this seam. To ensure its authenticity, it is examined before and during childbirth.

Additional indications for cesarean section during pregnancy are represented by two or more similar operations in the past, severe exposure to the previous post-operative period (fever, uterine inflammation, prolonged healing of the suture, multiple natural births that thinned the uterine wall).

Absolute indicators for CS from the fetus

1. Placental abruption ahead of schedule . When it separates during labor or before it begins, the woman may be exposed to heavy blood loss, and the fetus – acute hypoxia (lack of oxygen).
2. Placenta previa. A threatening situation that is detected on ultrasound. That's right, when it attaches to posterior region uterus. In this case, it is located in its lower third, or above the cervix and closes the exit for the fetus. This situation can intensify severe bleeding. Pathology when not bleeding, represents a diagnosis for a planned CS only at a later time in pregnancy. Before, there should be no panic, since the placenta is still able to take its normal position.
3. Transverse position of the fetus. Normally, a baby is born with the head or buttocks down. Typically, a transverse position occurs in multiparous women. Since the muscles of the uterus and abdominal wall already weakened. Other factors include polyhydramnios and placenta previa.
4. Umbilical cord prolapse. It is subject to compression between the head and the pelvic wall. This damages the blood flow between mother and baby.

Thus, the testimony of mother and baby, indicating the unreality of natural childbirth, is called absolute.

Relative indications for cesarean section during pregnancy

1. Extragenital anomalies– accompanying women's diseases, which are not related to her health in the field of gynecology. Existing pathologies at the birth of a baby can dangerously worsen. These include:

• various cancer concentrations,
• heart disease,
• high myopia with risk of retinal detachment,
• diabetes,
• diseases of the nervous system, kidneys and others (for example, genital herpes).

2. Gestosis in a pregnant woman- a deviation that threatens disaster, which occurs in a pregnant woman in the second half of gestation. There is a disturbance in the blood vessels, brain activity. The expectant mother has high blood pressure, protein in urine, swelling, headache, sometimes convulsions, the appearance of spots in front of you.
3. First birth in a woman over thirty-five years of age.
4. Narrow pelvis in a woman in labor. The baby's head will not enter the birth canal even with active contractions and full dilatation of the cervix. There will be a threat of its rupture and severe suffocation of the fetus. It is impossible to accurately determine the volume of his head before birth; moreover, it may deviate and be inserted incorrectly. Therefore, this parameter is diagnosed according to their progress.
5. Scar on the uterus. Becomes a risk factor for its rupture. Always under special medical attention. Sometimes associated with a previous CS and formed after induced abortion, or removal of fibroids.
6. Persistent weakness of labor. Represents its attenuation. Contractions begin to subside or disappear altogether. Medical support does not work. If the device shows that the baby is suffering, they resort to surgery.

Relative indications for CS on the part of the child

1. The fruit weighs more than four kilograms.
2. Breech presentation in natural childbirth. There is a risk of suffocation and injury. Everything becomes more complicated when the newborn is large and the mother has an anatomically narrowed pelvis.
3. Chronic or acute oxygen starvation of the baby. To identify it, they use the following methods: listen to the obstetrician with a stethoscope, examine the circulation of blood between the baby, uterus and placenta, study the movement and beating of the heart, and amniotic fluid.

When hypoxia is detected, when therapeutic effect does not give a positive result, a CS is prescribed to preserve the child’s health.

Taken separately relative reading does not become a basis for organizing a CC. But when making a decision to end pregnancy, the doctor takes a responsible approach to all the positive and negative aspects of any option. And when the operation becomes most in a safe way delivery for mother and baby, then the gynecologist makes an election in her favor.

There is also combined information on conducting a CS. They combine several factors, which together turn into a threat to life during independent childbirth. First of all, this is the detected hypoxia and postmaturity of the baby, breech presentation and heavy weight fruit, serious illness and age exceeding thirty-five years.

Requirements for the operation

Surgical intervention is organized subject to the following conditions:

• the woman's consent to her performance,
• vitality child,
• the presence of a highly qualified specialist and the availability of high-quality equipment;
• absence of infections.

Contraindications to caesarean section

The operation is undesirable when there is:

• purulent-septic complication in the mother,
• developmental pathology that is incompatible with the life of the baby,
• death of the fetus in the womb of a woman,
• major prematurity,
• prolonged suffocation of the baby and the occurrence of stillbirth.

If there is a possibility of the baby's death, the mother's life will be preserved during delivery. Health care with risk factors can cause infectious and septic complications (for example, inflammatory processes of the appendages, uterus, in the peritoneum), since the dead fetus will become a source of infection.

It is now clear that indications for caesarean section during pregnancy are not a reason to panic. How it will happen - delivery is very important, but life is more important and the health of mother and newborn. Only they become a priority for a competent doctor.

In this article:

Caesarean section refers to a series of surgical medical interventions in the human body. This operation is intended to resolve labor and extract the fetus by making an incision in the woman's abdominal wall and then cutting into the wall of the uterus. Indications for caesarean section are a number of pathologies and diseases of a pregnant woman. They entail the impossibility of childbirth occurring naturally due to various kinds complications dangerous to the life and health of the mother and unborn child.

The need for this type of intervention can be determined during pregnancy (then it can be planned or emergency), as well as already during childbirth. In this article we will consider the indications for planned and emergency CS surgery, as well as its indications during childbirth. But perhaps many readers will first be interested in learning a little about history, which has its roots in the distant past.

The history of childbirth caesarean section is associated with the name of the great ancient Roman figure- commander Gaius Julius Caesar. According to legend, he was brought into the world from his mother's womb through an incision in her stomach. The real CS operation performed by the famous doctor J. Trautman from Wittenberg in 1610 is documented for the first time. As for Russia, in our country the first such births were performed by V. M. Richter in 1842 in the city of Moscow.

Planned surgery

A planned caesarean section is called a cesarean section, the indications for which were established by the attending physician during pregnancy. The woman is admitted to the pathology department in advance of the day of surgery and undergoes necessary examination and preparation. During this period, specialists should evaluate physiological state women, reveal everything possible violations and risks, as well as assess the condition of the fetus. The anesthesiologist will talk with the woman in labor, talk about acceptable types of anesthesia, their advantages and possible consequences, will help you choose the most suitable option. He needs to be informed about the presence or absence of allergies or hypersensitivity to some drug components.

For a planned caesarean section, the indications may be as follows:

1. . This disorder is that the placenta (the location of the baby) moves to bottom part uterus and blocks the entrance to it. With this diagnosis there is a risk of severe bleeding, which is dangerous for both the mother and the unborn child. Therefore, the intervention is carried out at the 39th week of pregnancy, but possibly earlier if the appearance of bloody discharge is noticed.
2. According to the results of ultrasound, the scar on the uterus was found to be incompetent, that is, its thickness is less than 3 mm, its contours are uneven. This pathology may be a consequence of a previous CS or other surgical interventions on the uterus. This diagnosis is evidenced by various complications after surgery - elevated temperature bodies in recovery period, long-term healing external seam, inflammatory processes in the pelvic organs.
3. Several CS in history. If a woman has previously had two or more similar interventions, she is usually not allowed to go into labor, as this risks uterine rupture along the scar. The operation is scheduled; there is no need to wait for natural resolution to begin.
4. Uterine fibroids. When it is multiple and characterized by the location of a node in the cervix or the presence of large nodules whose nutrition is impaired, cesarean delivery is indicated.
5. Pathologies of the pelvic organs, including tumors of the uterus or its appendages, degree II and higher narrowing of the pelvis, and others.
6. Pathologies hip joints: ankylosis, congenital dislocation, previous operations.
7. The size of the fetus at the first birth is more than 4 and a half kilograms.
8. The cervix and vagina have pronounced cicatricial narrowings.
9. Severe symphysitis. This disease is characterized by divergence of the pubic bones to the sides. Clinical manifestations– difficulty walking, accompanied by pain.
10. Conjoined twins.
11. The number of fruits is more than two.
12. Incorrect placement of the fetus in late dates in primiparas (gluteo-leg).
13. The fruit is located transversely.
14. Cancer of the uterus and its appendages.
15. Genital herpes in the acute stage, which occurred 1-14 days before the end of pregnancy. CS is indicated when there are blistering-like rashes on the surface of the external genitalia.
16. Severe diseases of the kidneys, nervous system, cardiovascular systems, lung diseases, and sharp deterioration general condition health of a pregnant woman.
17. Chronic fetal hypoxia, its malnutrition (growth retardation), which cannot be treated with medications. In this case, the fetus does not receive the amount of oxygen it needs, and natural childbirth can result in serious injury.
18. The age of the woman at the first birth is over thirty years, combined with any other pathology.
19. Fetal malformations.
20. In vitro fertilization (especially if it happened more than once) in combination with other complications.
21. Also serious violation vision – indication for caesarean section. It is valid for myopia (diagnosis of myopia), which occurs in a woman in labor in a complex form, where there is a threat of retinal detachment.

Emergency caesarean section during pregnancy

Indications for urgent surgical intervention may include unforeseen situations or severe complications during pregnancy, when the life and health of the mother and fetus are at risk. Among them:

• Placental abruption. If the placenta is located normally, then its separation from the wall of the uterus should occur at the end of labor. But there are cases when the placenta detaches during pregnancy and is accompanied by heavy bleeding threatening the life of the fetus and mother.
• Symptoms of uterine rupture along a scar. When there is a threat of rupture, it is important to undergo urgent surgery in time, as loss of the fetus and removal of the uterus are possible.
• Acute fetal hypoxia, when the child’s heartbeat decreases sharply and cannot be restored.
• Transition of gestosis to severe form, the occurrence of preeclampsia and eclampsia.
• Placenta previa, sudden bleeding.

Caesarean during childbirth

If pathologies and disorders are discovered during childbirth, which are indications for cesarean section during pregnancy, and complications suddenly arise, it is necessary to perform an operation. Complications that may occur during childbirth:

• Rupture of the uterus along the scar.
• Violation of the correspondence between the pelvis of the woman in labor, which turned out to be clinically narrow, and the baby’s head.
• There are disturbances in uterine contractions that cannot or cannot be corrected.
• Fetal presentation feet first.
• Loss of umbilical cord loops.
• The outflow of amniotic fluid ahead of time, labor induction does not have any effect.

Possible consequences of cesarean section

Before, during and after a cesarean section, many women feel much better than if they had to undergo a vaginal delivery. This is explained by the fact that they do not have to worry about labor pains in advance. The second reason is that during artificial resolution the woman does not experience pain or suffering. And thanks to the fact that there are no stretch marks or tears in the perineum, after discharge from the hospital female body recovers much faster. Of course, if no unwanted complications arise.

However, do not delude yourself, because no one is immune from complications and unforeseen situations. Although this operation in combination with modern methods And medical equipment is reliable, proven and quite safe, its complications are possible.

• Surgical complications. During surgery, it is possible to accidentally hit a vascular branch when cutting the uterus, which may result in bleeding. Touching is also possible Bladder or intestines, and in in rare cases The fetus itself is injured.
• Complications due to anesthesiology. There is a risk after surgery uterine bleeding. It may occur due to the fact that uterine contraction is disrupted due to surgical trauma. It can also be caused by the effects of medications. A change in the physical and chemical composition of the blood, which necessarily occurs under the influence of anesthesia, can lead to thrombus formation and blockage of blood vessels.
• Purulent complications and infection. After a cesarean section birth, the sutures may fester, and it is still possible for them to separate.

You should also beware of endometritis (occurs as a result of inflammation of the uterus), adnexitis (when the appendages become inflamed), parametritis (the periuterine tissue becomes inflamed). To prevent these diseases, treatment with antibiotics during and after surgery is necessary.

As for the child, after medical intervention he may have problems with the respiratory system and their pathologies. In order to partially prevent this threat, the date elective surgery prescribed as close as possible to the date that marks the end of pregnancy. Also, CS can be a consequence of difficulties in breastfeeding.

The onset of lactation occurs late, since significant blood loss has occurred, the mother needs to recover from surgical stress, and the child’s adaptation to the new way of existence is disrupted. In addition, a woman needs to find a comfortable position for feeding, since the standard one - sitting with the baby in her arms - causes pain and discomfort, as the child puts pressure on the seam.

After a CS, disturbances in the functioning of the baby’s heart may occur, it is observed reduced level glucose and hormones thyroid gland. Visible excessive lethargy and child's drowsiness, muscle tone is lowered, the wound on the navel heals more slowly, and the immune system copes with its activities worse than in children born naturally. But using achievements modern medicine leads to restoration and normalization of the baby’s physiological indicators by the day of discharge.

The question that arises quite rightly among women, which is better - childbirth or cesarean - cannot be given a definite answer. Of course, it is always better what is inherent in nature itself, what is called natural and does not require additional intervention. Therefore, a caesarean section is not performed at the request of the woman, but only if there are necessary indications.

The doctor's story about when to do a caesarean section

Good day, dear readers! The other day I was able to talk to an old friend, she is pregnant again. While we were talking, she told me that she would have a caesarean section. Moreover, there are no medical indications, it’s just that her previous birth was very difficult, and this time she decided to immediately resort to surgery.

And then I thought - she herself chose this path. She has past experiences that have left their painful mark. But much more often it is doctors who prescribe CS. So why do caesarean sections? What does the gynecologist’s verdict depend on? I suggest you look into it.

Doctors always insist on natural childbirth, but not every woman manages to give birth on her own. In such cases, the gynecologist may refer the expectant mother for a CS.

This decision depends on various factors:

• there is a possibility of a threat to the health and life of the child;
• there is a possibility of a threat to the health and life of the mother.

Also, a caesarean section can be prescribed for the expectant mother for the following indications:

• absolute (there are contraindications to natural childbirth);
• relative (during natural childbirth, complications arose that resulted in a CS).

2. When a caesarean section is necessary

A caesarean section will be mandatory for the expectant mother in the following cases:

• the woman in labor has a too narrow pelvis (natural childbirth can have a negative impact on the mother’s health, especially if the fetus is large - there is a possibility that the baby will not be able to pass through the birth canal);
• varicose veins in the vaginal area (this phenomenon threatens severe blood loss for the mother);
• gestosis (this disease is characterized by spasms, increased pressure, swelling, which is unacceptable during natural childbirth);
• a scar on the uterus (if the scar has not healed, or its condition raises doubts among doctors, a CS is prescribed, since there is a possibility of its rupture);
• the location of the placenta blocks the birth canal;
• bleeding;
• uterine rupture (in this case, immediate assistance is required, as the rupture can lead to fatal outcome mother);
• vision problems (due to myopia or high degree myopia, future mom risks losing sight);
• heart disease;
• chronic diseases of the mother;
• IVF (since pregnancy is “artificial” - CS is prescribed to avoid possible complications);
• fetal hypoxia;
• unfavorable position of the fetus for natural birth (for example, the baby lies across the abdomen);
• incorrect position of the baby's head, preventing the passage of the fetus through the birth canal;
• entanglement of the fetus with the umbilical cord;
• mother's death.

Again, the list is not closed. Indications for cesarean section may vary from person to person. In any case, if a CS is prescribed, the doctor will fully consult the pregnant woman and explain why she is being referred for this operation.

3. When is a CS prescribed during childbirth?

Relative indications arise already during childbirth. That is, it was not initially established that the woman would not be able to give birth on her own. Such indications include:

• narrow pelvis (but, by clinical standards, that is, the size of the pelvis turned out to be insufficient for the child’s patency);
• labor activity weak (by physical reasons the expectant mother cannot give birth to a child herself);
• unfavorable position of the fetus (for example, the child tries to “come out” not with the “thin” part of the head, but with the wider side, which is dangerous for both the mother and the newborn);
• the child changed position from “vertical” to “horizontal”;
• a large fetus (there are cases when the weight of the child in the womb reaches 6 kilograms, in which case a CS may be prescribed);
• suffocation of a child (for example, due to lack of oxygen);
• pregnancy occurred after long-term treatment infertility;
• pregnancy period exceeds 41 weeks;
• previous births were performed by caesarean section;
• a woman gives birth over the age of 35-40;
• poor blood circulation;
• multiple births.

Other reasons may also be considered that will influence a physician's decision to switch from a vaginal birth to a cesarean section. For example, if a woman gave birth to her first child after 30 years of age and during the second pregnancy pathologies were noticed that affected the outcome of the birth.

4. What else you need to know about CS

Caesarean section is usually done no later than 39 weeks - this is the generally accepted time frame. In itself, a caesarean section is a kind of operation to “extract” a child from a woman’s body.

Distinguish several types of cesarean:

1. planned (for medical reasons);
2. emergency (transition from natural childbirth to caesarean section due to unforeseen circumstances);
3. planned (the woman tries to give birth on her own, but in case of any complications a caesarean section is performed);
4. at will (currently, the expectant mother has the right to insist on a CS without any contraindications).

4.1. Scheduled CS

A pregnant woman has contraindications for natural childbirth, which is why she undergoes a caesarean section. A planned cesarean section is prescribed during pregnancy. The doctors’ decision depends on the tests, the general condition of the patient, past childbirth experience and other factors.

A special feature of such births is the fact that the doctor may recommend not setting a specific date for the operation, but waiting for the start of natural labor (to prevent the baby from being premature). Once labor begins, the woman will be “operated on.”

But there are cases when planned birth are appointed earlier due date. A striking example is the “foot” position (breech presentation) of the fetus.

4.2. Emergency CS

You can read reviews on the Internet that some women were urgently prescribed a caesarean section during natural childbirth. That is, such an operation was not initially planned, but surgical intervention was required due to unforeseen circumstances.

The decision to perform an emergency caesarean section is made individually. For example, if during childbirth the fetus becomes entangled in the umbilical cord, the woman in labor may undergo an emergency “operation.” Or if labor is greatly weakened, the child does not receive enough oxygen, and so on.

5. Contraindications for surgery

There are no contraindications as such. There are only cautions, because CS can lead to an inflammatory process.

In case of inflammation, the young mother will be prescribed a course of treatment which is as follows:

1. the woman is prescribed medications (usually antibiotics);
2. bed rest is prescribed;
3. a course to improve the immune system is being carried out.

Moreover, the young mother is under constant medical supervision.

They say that not a single woman has ever returned from the maternity hospital pregnant! You know this is true, right? Therefore, you should not be afraid of childbirth, because a baby is the best reward!

Here you can see detailed information about caesarean section from Dr. Komarovsky:

And here you can watch a video from an obstetrician-gynecologist about in what cases a CS is done:

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