The cesarean section is the oldest intervention of humanity. If we look at the statistics, two thirds of cesarean sections are primary, which means that the pregnant woman has never had a delivery of this type, and the remaining third are repeat cesarean sections.
Regarding the proportion of cesarean sections that are performed, there is a diversity of data according to the authors, but the general statistics are over 15% of all deliveries. It depends on the type of hospital, if there are highly complex pregnancies and other factors. The center for preparation for childbirth and postpartum recovery Llevadonas explains everything you need to know about cesarean deliveries.
Dystocia -deliveries that do not evolve normally- are the most frequent causes in primary cesarean sections. “Difficult delivery” labor is divided into: disproportion between the mother’s pelvis and the size of the baby; dilation dystocia (dilation does not progress); descent dystocia (the baby cannot move down the birth canal); and stalled deliveries or failed inductions.
In the case of a previous elective cesarean section, the risk of maternal and fetal morbidity and mortality for a second cesarean delivery is higher than for a vaginal delivery. According to the latest studies, the success rate of a vaginal delivery after a previous cesarean section is 72 to 76%, reaching 90% if there has been a previous vaginal delivery. In this sense, pregnant women with a previous caesarean section should be offered the possibility of a vaginal delivery as long as there are no contraindications and after informing the pregnant woman about the benefits and risks of vaginal delivery.
The main risk after a first caesarean section is uterine rupture (1 in 100 cases). The symptoms are doubtful and may be masked by anesthesia or medication during the intervention. The rupture can occur because the previous scar of the uterus presents a minimum thickness. Various methods are currently being investigated to minimize the risk of breakage.
