Maternal and neonatal morbidity and mortality in cesarean section

Maternal mortality rates after cesarean delivery are low, but cesarean section is more hazardous than vaginal delivery by a factor of two to four. Operative complications can be minimized by careful technique and are more often seen in emergency than elective cases. Prophylactic antibiotics are of some benefit in reducing postoperative endometritis in patients with risk factors. Cesarean birth rarely causes the death of a newborn. Nevertheless, significant newborn pulmonary problems, especially respiratory distress syndrome, may follow an inappropriately timed cesarean delivery. Careful attention to clinical measures and supporting evidence of pulmonary maturity from ultrasound will avoid most instances of iatrogenic prematurity. Amniocentesis, with a higher complication rate than ultrasound, may still be required to prove pulmonary maturity in some circumstances. If concern or doubt precludes elective delivery of patients with previous low transverse uterine incisions, one can wait for the patient to go into spontaneous labor.