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Difficult caesarean section: A literature review.

Federica Visconti1, Paola Quaresima1, Erika Rania1

  • 1Department of Obstetrics and Gynecology, "Magna Grecia" University, Viale Europa, Loc., Germaneto, 88100, Catanzaro, Italy.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|January 22, 2020
PubMed
Summary

Difficult caesarean sections (CS) pose risks to mothers and fetuses. This review identifies common challenges in CS, offering insights into management, prevention, and complication resolution for safer surgical delivery.

Keywords:
DeliveryDifficult cesarean sectionFoetal complicationsMaternal complications

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Area of Science:

  • Obstetrics and Gynecology
  • Surgical Management
  • Evidence-Based Medicine

Background:

  • Caesarean section (CS) is often viewed as safe but can present significant technical difficulties.
  • These challenges pose health risks to both mother and fetus.
  • Effective management strategies are crucial for mitigating these risks.

Purpose of the Study:

  • To conduct an evidence-based literature review of common difficult caesarean section scenarios.
  • To provide information on the management, prevention, and complication resolution of difficult CS.
  • To enhance surgical planning and patient safety.

Main Methods:

  • Comprehensive literature search of PubMed, Scopus, Web of Science, and Ovid MEDLINE (1979-2019).
  • Inclusion of high-quality evidence: RCTs, non-randomized trials, case-control, cohort studies, and case series.
  • Selection of approximately 60 relevant articles after excluding 436 unsuitable studies.

Main Results:

  • Difficult CS causes categorized into four main areas: access to the lower uterine segment, fetal extraction complications, organ damage, and abnormal placentation.
  • Identification of specific challenges within each category.
  • Synthesis of findings to inform clinical practice.

Conclusions:

  • Anticipating potential technical difficulties in CS is essential for surgical planning.
  • Proactive strategies can minimize risks and improve outcomes for difficult caesarean sections.
  • Knowledge of challenging scenarios aids in developing effective management plans.