Cesarean section is indicated in situations where normal delivery would present greater risk for the woman and the baby, such as in the case of placenta previa or placental abruption, uterine rupture, fetal distress or even the wrong position of the baby. In these cases, a cesarean may be recommended as an emergency surgery.
However, cesarean section is still a surgery that can have some associated complications, such as risk of infections where the cut was made or bleeding and, therefore, this surgery should be evaluated by the obstetrician, as in cases of gestational diabetes or labor. prolonged and without complete dilation, for example.
The decision for cesarean section must be made by the obstetrician taking into account the woman’s desire to have a normal birth or not and the general state of health. Although normal delivery is the best way for the baby to be born, it is sometimes contraindicated, requiring a cesarean section and it is up to the doctor to make the final decision after checking the health status of the woman and the baby.
Some situations in which a cesarean section is indicated are:
1. Placenta previa or placental abruption
Placenta previa happens when it is fixed in a place that prevents the baby from passing through the birth canal, and it is possible for the placenta to come out before the baby. Placental detachment occurs when it detaches from the uterus before the baby is born.
The indication of cesarean section for these situations is because the placenta is responsible for the arrival of oxygen and nutrients to the baby and when it is compromised, the baby is harmed by the lack of oxygen, which can lead to brain damage.
2. Uterine rupture
Uterine rupture, also known as uterine rupture, is a serious obstetric complication in which the uterine musculature is ruptured during the last trimester of pregnancy or at the time of delivery, which can result in excessive bleeding and severe abdominal pain. risk the life of the woman and the baby, in which case immediate cesarean section is recommended.
3. Prior vasa rupture
Vasa previa is a condition in which the membranes that contain blood vessels that connect the umbilical cord to the placenta, are close to or pass through the cervix, and can rupture and cause heavy bleeding in the woman and the baby, being considered a situation of obstetric emergency, in which cesarean section must be performed immediately.
4. Eclampsia or preeclampsia
Preeclampsia is a pregnancy complication characterized by increased blood pressure and excess protein in the urine, which can progress to eclampsia, in which repeated episodes of seizures occur, followed by coma, which can be fatal if not treated immediately. . In these cases, a cesarean may be recommended by the obstetrician as soon as possible.
5. HELLP Syndrome
HELLP syndrome is a set of changes that can occur in pregnancy, especially in the third trimester of pregnancy, and which are characterized by the destruction of red blood cells, increase in liver enzymes and decrease in the amount of platelets in the blood.
This syndrome is usually associated with preeclampsia or eclampsia, and can put the life of the woman and the baby at risk, being recommended by the obstetrician induced delivery if it occurs after the 34th gestation, and the woman is stable, or a cesarean section. , early, to avoid complications for the woman or the baby. Understand better what HELLP syndrome is and how it is treated.
6. Babies with syndromes or diseases
Babies who have been diagnosed with some kind of syndrome, disease or malformations, such as hydrocephalus or omphalocele, which is when the baby’s liver or intestines are outside the body, should always be delivered by cesarean section. This is because the process of normal birth can damage the organs in the case of omphalocele, and uterine contractions can damage the brain in the case of hydrocephalus.
7. When the mother has STIs
When the mother has a sexually transmitted infection (STI), such as active genital herpes, the baby can be contaminated at the time of the baby’s passage through the vaginal canal and, therefore, it is more appropriate to have a cesarean delivery.
For women who have HIV infection, elective cesarean section is indicated when the woman is not on antiretroviral therapy, the CD4 count is low or unknown, and/or the viral load is unknown or greater than 1000.
However, if the woman undergoes treatment for the specific STI she has, and the infection is controlled, she can attempt a normal delivery.
8. When the umbilical cord comes out first
During labor, the umbilical cord may pass through the cervix and exit through the vaginal opening before the fetus. This situation is known as umbilical cord prolapse, and it increases the risk of the baby running out of oxygen, in which case emergency cesarean is recommended by the obstetrician.
9. Wrong baby position
If the baby remains in any position, other than upside down, such as lying on its side or with its head up, and does not turn over until before delivery, it is better to have a cesarean section because there is a greater risk for the woman and the baby, as the contractions are not strong enough, making normal delivery more complicated.
Cesarean section can also be indicated when the baby is upside down but is positioned with the head slightly turned backwards with the chin facing upwards, this position increases the size of the baby’s head, making it difficult to pass through the hip bones of the baby. mom.
10. In case of twins
In twin pregnancy, when both babies are properly turned upside down, delivery may be normal, however, when one of them has not turned until delivery, it may be more advisable to have a cesarean section. When they are triplets or quadruplets, even if they are upside down, it is more advisable to have a cesarean.
Also, cesarean section is indicated in the case of conjoined twins, which are identical twins who have body parts joined together.
11. Fetal distress
When there is a change or decrease in the baby’s heartbeat, decrease in fetal movements and decrease in the volume of amniotic fluid, there are indications of fetal distress and in this case a cesarean section may be necessary, because, with the weakest beats, the baby may lack of oxygen in the brain, which leads to brain damage, such as motor impairment or cerebral palsy, for example.
