Birth - Caesarean Delivery
The term "caesarean" comes from the historic description of Julius Ceasar's birth, though probably ficticious as his mother Aurelia survived his birth. The procedure involves surgically cutting skin, abdominal wall and uterus to allow abdominal delivery.
The rate of caesarean delivery compared to normal vaginal birth is variable between countries (12-25%, 20% of all births in Australia) and increasing, particularly in older women. There are a number of different explanations as to why this is occuring, including maternal or fetal complications of either development or delivery.
Importantly this is a maternal surgical procedure which requires time for recovery and there are several studies that have looked also into the effects of caesarean delivery on potential future normal vaginal births.
Please note the UK/Australian "Caesarean" versus USA "Cesarean" spelling differences. Clinically, cesarean section may also be abbreviated to c-section or C/S.
Video Webcast: Hartford Hospital Cesarean Childbirth (September 23rd, 2005)
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Some Recent Findings
|More recent papers|
This table shows an automated computer PubMed search using the listed sub-heading term.
References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability.
Razieh Khalooei Fard, Zohre Tabassi, Mostafa Qorbani, Saeed Hosseini The Effect of Preoperative Oral Carbohydrate on Breastfeeding After Cesarean Section: A Double-Blind, Randomized Controlled Clinical Trial. J Diet Suppl: 2017;1-7 PubMed 28937862
Katharina Langton, Matthias Gruber, Jimmy Masjkur, Charlotte Steenblock, Mirko Peitzsch, Jörn Meinel, Jacques Lenders, Stefan Bornstein, Graeme Eisenhofer Hypertensive crisis in pregnancy due to a metamorphosing pheochromocytoma with postdelivery Cushing's syndrome. Gynecol. Endocrinol.: 2017;1-5 PubMed 28937294
Martijn J Cornelissen, Madiha Söfteland, Inge Apon, Lars Ladfors, Irene M J Mathijssen, Titia E Cohen-Overbeek, Gouke J Bonsel, Lars Kölby Perinatal complications in patients with unisutural craniosynostosis: An international multicentre retrospective cohort study. J Craniomaxillofac Surg: 2017; PubMed 28935489
Islam Gamaleldin, David Harding, Dimitrios Siassakos, Tim Draycott, David Odd "Significant intraventricular hemorrhage is more likely in very preterm infants born by vaginal delivery: A multi-centre retrospective cohort study". J. Matern. Fetal. Neonatal. Med.: 2017;1-17 PubMed 28934915
S Goland, I M van Hagen, G Elbaz-Greener, U Elkayam, A Shotan, W M Merz, S C Enar, I R Gaisin, P G Pieper, M R Johnson, R Hall, A Blatt, J W Roos-Hesselink Pregnancy in women with hypertrophic cardiomyopathy: data from the European Society of Cardiology initiated Registry of Pregnancy and Cardiac disease (ROPAC). Eur. Heart J.: 2017, 38(35);2683-2690 PubMed 28934836
USA Caesarean Rate by Gestational Age
Latest 2013 data
Trial of Labor
Trial of Labor (TOL) or trial of labor after cesarean (TOLAC) is a term used in relation to the offer for a normal vaginal delivery after a previous cesarean delivery. The resulting birth is described as vaginal birth after cesarean (VBAC), in recent years this option has been decreasing while the general caesarian rate increases.
(increased likelihood of successful VBAC)
- Maternal age <40 years
- Prior vaginal delivery (particularly prior successful VBAC)
- Favorable cervical factors
- Presence of spontaneous labor
- Nonrecurrent indication that was present for prior cesarean delivery
(decreased likelihood of successful VBAC)
- Increased number of prior cesarean deliveries
- Gestational age >40 weeks
- Birth weight >4,000 g
- Induction or augmentation of labor
There is no standard clinical classification system for caesarean delivery, with at least 27 classifications identified. Recent studies of data from several countries suggests that the 10 group classification system (Robson Classification), or a modification of this system, may be the current best applied system.
The Robson's classification (10 group classification) is based on several simple obstetrical parameters; parity, previous CS, gestational age, onset of labour, fetal presentation and the number of foetuses. The classification categories are totally inclusive and also mutually exclusive.
- Links: WHO Robson Classification
- Michael Stark, Ospan Mynbaev, Yuri Vassilevski, Patrick Rozenberg Could Revision of the Embryology Influence Our Cesarean Delivery Technique: Towards an Optimized Cesarean Delivery for Universal Use. AJP Rep: 2016, 6(3);e352-e354 PubMed 28078171
- O Naji, L Wynants, A Smith, Y Abdallah, S Saso, C Stalder, S Van Huffel, S Ghaem-Maghami, B Van Calster, D Timmerman, T Bourne Does the presence of a Caesarean section scar affect implantation site and early pregnancy outcome in women attending an early pregnancy assessment unit? Hum. Reprod.: 2013, 28(6);1489-96 PubMed 23585560
- F Gary Cunningham, Shrikant I Bangdiwala, Sarah S Brown, Thomas Michael Dean, Marilynn Frederiksen, Carol J Rowland Hogue, Tekoa King, Emily Spencer Lukacz, Laurence B McCullough, Wanda Nicholson, Nancy Frances Petit, Jeffrey Lynn Probstfield, Adele C Viguera, Cynthia A Wong, Sheila Cohen Zimmet NIH consensus development conference draft statement on vaginal birth after cesarean: new insights. NIH Consens State Sci Statements: 2010, 27(3);1-42 PubMed 20228855
- Ana P Betrán, A Metin Gulmezoglu, Michael Robson, Mario Merialdi, João P Souza, Daniel Wojdyla, Mariana Widmer, Guillermo Carroli, Maria R Torloni, Ana Langer, Alberto Narváez, Alejandro Velasco, Anibal Faúndes, Arnaldo Acosta, Eliette Valladares, Mariana Romero, Nelly Zavaleta, Sofia Reynoso, Vicente Bataglia WHO global survey on maternal and perinatal health in Latin America: classifying caesarean sections. Reprod Health: 2009, 6;18 PubMed 19874598
- Pisake Lumbiganon, Malinee Laopaiboon, A Metin Gülmezoglu, João Paulo Souza, Surasak Taneepanichskul, Pang Ruyan, Deepika Eranjanie Attygalle, Naveen Shrestha, Rintaro Mori, Duc Hinh Nguyen, Thi Bang Hoang, Tung Rathavy, Kang Chuyun, Kannitha Cheang, Mario Festin, Venus Udomprasertgul, Maria Julieta V Germar, Gao Yanqiu, Malabika Roy, Guillermo Carroli, Katherine Ba-Thike, Ekaterina Filatova, José Villar, World Health Organization Global Survey on Maternal and Perinatal Health Research Group Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08. Lancet: 2010, 375(9713);490-9 PubMed 20071021
- Stuart Howell, Trisha Johnston, Sue-Lynne Macleod Trends and determinants of caesarean sections births in Queensland, 1997-2006. Aust N Z J Obstet Gynaecol: 2009, 49(6);606-11 PubMed 20070708
- Erin A S Clark, Robert M Silver Long-term maternal morbidity associated with repeat cesarean delivery. Am. J. Obstet. Gynecol.: 2011, 205(6 Suppl);S2-10 PubMed 22114995
- Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2013. National vital statistics reports; vol 64 no 1. Hyattsville, MD: National Center for Health Statistics. 2015. http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf
- Ana Pilar Betrán, Nadia Vindevoghel, Joao Paulo Souza, A Metin Gülmezoglu, Maria Regina Torloni A systematic review of the Robson classification for caesarean section: what works, doesn't work and how to improve it. PLoS ONE: 2014, 9(6);e97769 PubMed 24892928 | PLoS One.
- Maria Regina Torloni, Ana Pilar Betran, Joao Paulo Souza, Mariana Widmer, Tomas Allen, Metin Gulmezoglu, Mario Merialdi Classifications for cesarean section: a systematic review. PLoS ONE: 2011, 6(1);e14566 PubMed 21283801 | PLoS One.
- M S Robson Can we reduce the caesarean section rate? Best Pract Res Clin Obstet Gynaecol: 2001, 15(1);179-94 PubMed 11359322
Caesarean Section NICE Clinical Guidelines, No. 13 National Collaborating Centre for Women's and Children's Health (UK). London: RCOG Press; 2004 Apr. ISBN-10: 1-904752-02-0 Bookshelf
D Horey, J Weaver, H Russell Information for pregnant women about caesarean birth. Cochrane Database Syst Rev: 2004, (1);CD003858 PubMed 14974041
- Journal of American Medical Association JAMA Patient Page: Cesarean Delivery (USA) - one page Caesarean delivery information sheet (PDF)
- electronic Med J Aust Caesarean section: a matter of choice? by de Costa, C.M. MJA 1999; 170: 572-573
Jill Milne, Amiram Gafni, Diane Lu, Stephen Wood, Reg Sauve, Sue Ross Developing and pre-testing a decision board to facilitate informed choice about delivery approach in uncomplicated pregnancy. BMC Pregnancy Childbirth: 2009, 9;50 PubMed 19874628
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Cite this page: Hill, M.A. 2017 Embryology Birth - Caesarean Delivery. Retrieved September 26, 2017, from https://embryology.med.unsw.edu.au/embryology/index.php/Birth_-_Caesarean_Delivery
- © Dr Mark Hill 2017, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G