Cesarean section upon request: is it appropriate for everybody?
- PMID: 15843257
- DOI: 10.1515/JPM.2005.019
Cesarean section upon request: is it appropriate for everybody?
Abstract
The request for cesarean section without medical indication has become one of the dilemmas faced by the obstetrician. Most recent studies that compare vaginal delivery with elective cesarean section find them equally safe. This comparison is lacking in the option of trial of labor, which may result in an assisted vaginal delivery or intrapartum cesarean section, both with increased morbidity and mortality for the mother and newborn. When considering elective cesarean section, the obstetrician has to take into account improved anesthetic techniques and the decrease in morbidity and mortality after cesarean section with the trend toward patient autonomy to decide on her own treatment. On the other hand, the obstetrician has to advise his patient of the best treatment with respect to possible complications in future pregnancies, such as placental complications and increased morbidity and mortality resulting from repeated cesarean sections. The advantage of cesarean section for pelvic floor protection does not exist after three consecutive cesarean sections and equals the rate of urinary incontinence after consecutive three vaginal deliveries. In countries such as ours, where most women wish for several children, the risk-benefit balance is toward repeated spontaneous vaginal deliveries.
Comment in
-
Reply to: Cesarean section upon request: is it appropriate for everybody?J Perinat Med. 2005;33(2):112. doi: 10.1515/JPM.2005.020. J Perinat Med. 2005. PMID: 15843258 No abstract available.
Similar articles
-
Cesarean section on request at 39 weeks: impact on shoulder dystocia, fetal trauma, neonatal encephalopathy, and intrauterine fetal demise.Semin Perinatol. 2006 Oct;30(5):276-87. doi: 10.1053/j.semperi.2006.07.009. Semin Perinatol. 2006. PMID: 17011400 Review.
-
Cesarean section: does it really prevent the development of postpartum stress urinary incontinence? A prospective study of 363 women one year after their first delivery.Neurourol Urodyn. 2004;23(1):2-6. doi: 10.1002/nau.10166. Neurourol Urodyn. 2004. PMID: 14694448
-
Cesarean delivery on maternal request: wise use of finite resources? A view from the trenches.Semin Perinatol. 2006 Oct;30(5):305-8. doi: 10.1053/j.semperi.2006.07.012. Semin Perinatol. 2006. PMID: 17011403
-
Pelvic floor morbidity up to one year after difficult instrumental delivery and cesarean section in the second stage of labor: a cohort study.Am J Obstet Gynecol. 2004 Jul;191(1):4-10. doi: 10.1016/j.ajog.2004.01.013. Am J Obstet Gynecol. 2004. PMID: 15295337
-
Urinary incontinence: is cesarean delivery protective?Semin Perinatol. 2006 Oct;30(5):267-71. doi: 10.1053/j.semperi.2006.07.007. Semin Perinatol. 2006. PMID: 17011398 Review.
Cited by
-
Defensive Medicine in the Management of Cesarean Delivery: A Survey among Italian Physicians.Healthcare (Basel). 2021 Aug 25;9(9):1097. doi: 10.3390/healthcare9091097. Healthcare (Basel). 2021. PMID: 34574870 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical