Caesarean Section in Low-, Middle- and High-Income Countries

Abstract

Caesarean section (CS) refers to delivery of a foetus through surgical incisions made through abdominal and uterine walls. It's a life-saving procedure when complications arise during pregnancy. It may be an emergency or a planned procedure. Although desirable, CS may be medically unnecessary. CS is a major procedure associated with imme diate and long-term maternal and perinatal risks and may have implications for future pregnancies. Since 1985, international healthcare community considers ideal rate for CS to be 10-15%. However, in the last decade, there has been concern about the rising rates of CS from as low as 2% in Africa to as high as 50-60% in Dominican Republic and Latin America. To this effect, there have been attempts to regulate the rates, and the Ten Group Classification System under the Robson criteria is such an attempt. CS rates are on the increase due to varying reasons ranging from patient, institutional, care provider and societal factors. There have been modifications in the CS technique and the drugs used postoperatively from Pitocin to addition of Misoprostol. Need has developed from Reproductive Health Specialists to review indications, rates and terminologies used and evaluate practices in low-, middle-and high-income countries regarding CS.

Classifying caesarean section to understand rising rates among Palestinian refugees: results from 290,047 electronic medical records across five settings

“…Some of the benefits of VBAC documented included lower rates of maternal morbidity and mortality and shorter recovery compared to repeated caesarean-sections [42]. Repeated caesarean-sections in the context of high parity pose complications including abnormal placental adherence, bowel, and bladder injury and may require emergency hysterectomy [43], in the index pregnancy [44], and have serious implications for future pregnancies [43].…”

Effect of Wound Care Guidelines on Women's Knowledge, Beliefs, and Practices Regarding Cesarean Section Wound Healing

“…Caesarean section (CS) refers to delivery of a fetus through surgical incisions made through the abdominal and uterine walls. It's a life-saving surgical intervention achieved when complications occur during pregnancy or labour (Byamugisha et al, 2020).…”

Post-Supravaginal Hysterectomy for Bladder Flap Hematoma in P3A0 Preterm Delivery by Cesarean Section due to Fetal Distress

“…This action is done to reduce complications of pregnancy and childbirth and reduce maternal and infant mortality. CS can be done in an emergency or planned way [1]. The indications for CS surgery can be divided into two classifications: absolute and relative, where the choice of delivery method exists, but cesarean section provides the best chance of safety for the mother and her child.…”