Caesarean section: what are the cases in which it is really needed

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Catherine Le Nevez
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It may seem mechanical, not natural. The solution that is used when the baby and the mother are in difficulty. But it is life. It is the coming into the world of a new ...





In Del Paese, caesarean delivery is widespread: according to the latest Istat data available, in 2022 the caesarean sections were the 36,3% of the total, while the World Health Organization believes they should not exceed 15%. But when is caesarean section really indicated? This question is answered by the guidelines of the Higher Institute of Health for an "appropriate and conscious" choice (here the technical document and here the version for the public), specifying the situations in which the use of a caesarean section is recommended.



 

1. Emergency situations,

that can be life-threatening for the mother or baby, such as preeclampsia or umbilical cord prolapse in labor, which could reduce the oxygen supply to the fetus.




2. If the fetus has a breech presentation.

Breech baby, what can be done


3. In case of twin pregnancies,


If the twins have two placentas and two sacs (bicoronic and biamonite pregnancies) and both have cephalic presentation, guidelines recommend vaginal delivery. If one of the two has breech presentation, most centers recommend a caesarean, but in reality there are no conclusive scientific data in favor of this preference, so the situation must be evaluated case by case.


4. If the placenta is previa,


5. In some cases of fetal growth retardation


6. It the mother is diabetic and the fetus is large


7. In the presence of some maternal infections

Herpes simplex


For hepatitis C and B, the guidelines do not recommend routine caesarean section.


8. Having already given birth, even twice, by caesarean section, is not an absolute indication

if there have been three or more previous caesareans and if there have been uterus ruptures or other surgeries that have left longitudinal scars on the uterus

VBAC, natural delivery after a cesarean

When the caesarean is not needed

When, on the other hand, is a caesarean not necessary? "Diseases such as myopia, a herniated disc, or hemorrhoids are not an elective indication for surgery" says Stefano Bianchi, director of the gynecology and obstetrics unit of the San Giuseppe Hospital in our city.

He adds: "In cases of non-obstetric relevance, for example when the mother suffers from some chronic disease, the situation must always be evaluated by the reference specialist in synergy with the gynecologist, to assess whether the conditions that make the caesarean inevitable exist. ".

Sources for this article: Guidelines on Caesarean section: a conscious choice; advice from Stefano Bianchi, director of the gynecology and obstetrics unit of the San Giuseppe Hospital in our city.

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- Updated on 20.03.2022

TAG:
  • Caesarean section
  • Caesarean section
  • give birth
  • Caesarean section reasons
  • malposition of the fetus
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