Indications for cesarean section

Indications for cesarean section- elective

In a normal physiological pregnancy, the birth of choice is a road and natural force delivery. However, there are situations in which it is necessary to plan delivery by cesarean section. Planned, or elective, cesarean section is always performed in cases:

• monochorionic twin pregnancies,
• The transverse position of the child,
• The pelvic position of the baby in the 1st pregnancy,
• non-head first fetal position in twin pregnancies,
• Pregnant women with Marfan syndrome,
• Women with advanced heart failure (NYHA stages III and IV),
• When the estimated fetal weight is 4,500 or more (or 4,250 g or more in women with diabetes),
• Women after 2 or more cesarean sections.

Indications for cesarean section- emergency

Obstetrics is a medical field in which many things cannot be planned. One of them is emergencies that require an immediate decision to perform a cesarean section. These are referred to as emergency and urgent indications for cesarean section. Operations are then performed in situations such as:

• placental separation,
• anterior placenta,
• Threatened uterine rupture,
• Threatened fetal asphyxia,
• eclampsia,
• umbilical cord prolapse,
• lack of progress in labor.

Indications for cesarean section- tocophobia

The most common non-obstetric indication for a cesarean section is tocophobia, or fear of childbirth, the pain associated with it and possible complications. This is because diagnosed tokophobia and panic anxiety of a pregnant woman can lead to obstruction or even lack of cooperation with the parturient during labor, potentially significantly hindering the very course and safety of labor. Most often, if a pregnant woman suffers from tocophobia and is afraid of natural childbirth, it is necessary to consult a psychiatrist who will recommend appropriate therapy or treatment. In many hospitals, the lack of results from tocophobia treatment and persistent symptoms are an indication for an elective cesarean section.

Indications for cesarean section- extra-obstetrical

Among non-obstetric indications for cesarean section, psychiatric and orthopedic indications are the most commonly mentioned. Among the former, in addition to tocophobia, indications for cesarean section include. Schizophrenia or aggravated neurosis or psychotic states. In each of these cases, it is about the fear and risk of not cooperating with the parturient during labor. Orthopedic indications for cesarean section, on the other hand, are most often related to diseases of the spine and hip joints that prevent the safe positioning of the future mother during natural childbirth.  

Among extra-obstetric indications, ophthalmologic and oncologic indications are also present. In addition, infectious indications, e.g., primary genital herpes infection in III. trimester is an indication for a cesarean section.

The decision related to the performance of a cesarean section is always made by a gynecologist on the basis of recommendations, the results of examinations of the mother-to-be, and often in the case of extra-obstetric indications, after consultation with a specialist in another field.

Read more:
Cesarean section-all you need to know