Delivery of a baby through a surgical incision in the abdomen and uterus

Classification

• Caesarean sections can be classified as either ‘elective’ (planned) or ‘emergency’

Indications for an elective Caesarean

• Previous caesarean
• Symptomatic after previous perineal tear
• Placenta praevia
• Vasa praevia
• Multiple pregnancy
• Uncontrolled HIV
• Cervical cancer

Indications for an emergency caesarean

• Category 1: immediate threat to life of mother and baby
  • Decision to delivery time is 30 minutes
• Category 2: no imminent threat to life but required urgently due to compromise of mother or baby
  • Decision to delivery is 75 minutes
• Category 3: Deliver is required but mother and baby are stable
• Category 4: Elective caesarean

Complications

• General complications associated with surgery
  • Bleeding
  • Infection/sepsis
  • Pain
  • Damage to local structures (Ureter, bladder, bowels)
• Aspiration pneumonia
• Postpartum haemorrhage