C-section

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Cesarean section

C-section

Definition:

A C-section, also called a cesarean section, is the delivery of a baby through a surgical abdominal incision.

Alternative Names:

Abdominal delivery; Abdominal birth; Cesarean section

Description:

A C-section delivery is performed when a vaginal birth is not possible or is not safe for the mother or child.

Surgery is usually done while the woman is awake but anesthetized from the chest to the legs by epidural or spinal anesthesia. An incision is made across the abdomen just above the pubic area. The uterus is opened, the amniotic fluid is drained, and the baby is delivered.

The baby's mouth and nose are cleared of fluids, and the umbilical cord is clamped and cut. The baby is handed to the pediatrician or nurse who will make sure that breathing is normal. The mother is awake and she can hear and see her baby.

Due to a variety of medical and social factors, C-sections have become fairly common -- about 26% of all births in the United States in 2002 were C-sections.

Indications:

The decision to have a C-section delivery can depend on the obstetrician, the delivery location, and the woman's past deliveries or medical history. Some of the main reasons for C-section instead of vaginal delivery include the following:

Reasons related to the baby:

Developmental abnormalities of the fetus, such as hydrocephalus or spina bifida
Abnormal fetal heart rate pattern
Abnormal position of the baby within the uterus, such as crosswise (transverse) or buttocks-first (breech)
Multiple babies within the uterus (triplet and some twin pregnancies)

Reasons related to the mother:

Extreme maternal illness, such as heart disease, toxemia, preeclampsia or eclampsia
Active genital herpes infection
Maternal HIV infection
Previous surgery in the uterus, including myomectomy and previous C-sections

Problems with labor or delivery:

Prolonged or arrested labor
Very large baby (macrosomia)
Cephalopelvic disproportion (baby's head is too large to pass through mother's pelvis)

Problems with the placenta or unbilical cord:

Umbilical cord prolapse (the umbilical cord comes through the cervix)
Placenta attached in abnormal location (placenta previa) or prematurely separated from uterine wall (placenta abruptio)

Review Date: 6/6/2006
Reviewed By: Audra Robertson, MD, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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