It is an operative procedure where in fetuses is delivered through an incision on the abdominal wall and uterine walls after the end of 28th week. If it is performed for the first time it is called first caesarean section and if it is repeated in subsequent pregnancies it is called repeat caesarean section.

 

The name of the operation is derived from the lex cesarean which is a Roman law in 715 B.C. which was continued even during Caesars reign. The law provided either an abdominal delivery in a dying woman with a hope to get a live baby or to perform postmortem abdominal delivery for separate burial.

 Indications for caesarean section

Absolute indications: Is indicated in which the caesarean section is done vaginal delivery is impossible:

• Contracted pelvis.
• Cephalopelvic disproportion.
• Central placenta previa.
• Advanced carcinoma cervix.
• Vaginal obstruction as in vaginal atresia, stenosis

Relative indications: In this vaginal delivery is possible with or with out aids, but risks to the mother or baby is high:

• Previous caesarean section.
• Fetal distress.
• Dystocia.
• Ante partum hemorrhage.
• Malpresentations of the fetuses like breech, shoulder.
• Failed surgical induction of labor.
• Failure to progress in labour.
• Bad obstetric history with recurrent fetal wastage.
• Hypertensive disorders like eclampsia.
• Medical and gynecological disorders like Diabetes, heart disease, malignant tumors, peliv tumors

 Types of operation

• Lower segment caesarean section: In this the extraction of the baby is done though an incision in the lower segment. It is the only method practiced in present day.
• Classical or upper segment caesarean section: It was practiced in the past. It is done  now a days when the lower segment caesarean section is difficult like as in big fibroid on the lower segment, carcinoma cervix.

Complications

• Bleeding.
• Bladder injury.
• Infections.
• Intestinal obstruction.
• Anesthetic hazards: like aspiration, low blood pressure, headache.
• Wound infections.