Cesarean section upon request: is it appropriate for everybody?
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Assaf Ben-Meir
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.
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©2005 by Walter de Gruyter Berlin New York
Articles in the same Issue
- Declining fertility in the developed world and high maternal mortality in developing countries – how do we respond?
- Maternal obesity and complications during pregnancy
- Cesarean section upon request: is it appropriate for everybody?
- Reply to: Cesarean section upon request: is it appropriate for everybody?
- Characteristics of mothers who delivered the heaviest, average-weight, and lightest triplet sets
- Gestational age-specific distribution of twin birth weight discordance
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- Optimal timing for postprandial glucose measurement in pregnant women with diabetes and a non-diabetic pregnant population evaluated by the Continuous Glucose Monitoring System (CGMS®)
- Structural-tridimensional study of yolk sac in pregnancies complicated by diabetes
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- The association of birthweight with maternal and cord serum and amniotic fluid growth hormone and insulin levels, and with neonatal and maternal factors in pregnant women who delivered at term
- Amniotic fluid lamellar body counts for the determination of fetal lung maturity: an update
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Articles in the same Issue
- Declining fertility in the developed world and high maternal mortality in developing countries – how do we respond?
- Maternal obesity and complications during pregnancy
- Cesarean section upon request: is it appropriate for everybody?
- Reply to: Cesarean section upon request: is it appropriate for everybody?
- Characteristics of mothers who delivered the heaviest, average-weight, and lightest triplet sets
- Gestational age-specific distribution of twin birth weight discordance
- The comparison of amino-terminal probrain natriuretic peptide levels in preeclampsia and normotensive pregnancy
- Optimal timing for postprandial glucose measurement in pregnant women with diabetes and a non-diabetic pregnant population evaluated by the Continuous Glucose Monitoring System (CGMS®)
- Structural-tridimensional study of yolk sac in pregnancies complicated by diabetes
- Is cervical dilatation during parturition at term associated with apoptosis?
- Increased soluble VCAM-1 serum levels in preeclampsia are not correlated to urinary excretion or circadian blood pressure rhythm
- The association of birthweight with maternal and cord serum and amniotic fluid growth hormone and insulin levels, and with neonatal and maternal factors in pregnant women who delivered at term
- Amniotic fluid lamellar body counts for the determination of fetal lung maturity: an update
- Comparison of clinical criteria with echocardiographic findings in diagnosing PDA in preterm infants
- Sudden infant death syndrome “gray zone” disclosed only by a study of the brain stem on serial sections
- Incidence and diagnosis of unilateral arterial cerebral infarction in newborn infants
- Non-hydropic intrauterine fetal death more than 5 months after primary parvovirus B19 infection
- A new syndrome of myopathy with muscle spindle excess*
- Causes of left ventricular hypertrabeculation/non-compaction in a neonate and her mother
