48. Cesarean Delivery

  1. John T. Queenan MD2,
  2. Catherine Y. Spong MD3 and
  3. Charles J. Lockwood MD4
  1. Michael W. Varner MD

Published Online: 4 JAN 2012

DOI: 10.1002/9781119963783.ch48

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

How to Cite

Varner, M. W. (2012) Cesarean Delivery, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch48

Editor Information

  1. 2

    Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA

  2. 3

    Bethesda, MD, USA

  3. 4

    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Author Information

  1. University of Utah Health Sciences Center, Salt Lake City, UT, USA

Publication History

  1. Published Online: 4 JAN 2012
  2. Published Print: 24 FEB 2012

ISBN Information

Print ISBN: 9780470655764

Online ISBN: 9781119963783

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Keywords:

  • cesarean delivery (CD);
  • CD, in Western obstetric practice;
  • maternal, perinatal morbidity and mortality;
  • evidence-based operative considerations;
  • abdominal surgical incision, Joel-Cohen incision;
  • vaginal antiseptic prophylaxis;
  • single-layer versus two-layer hysterotomy closure;
  • risks of repeat cesarean delivery;
  • indications for primary CD, failure to progress in labor;
  • fetal distress

Summary

By the mid-20th century, cesarean delivery was firmly established in Western obstetric practice, primarily as a procedure to improve maternal outcomes in labor. With the evolution of neonatal medicine through the latter half of the century, cesarean delivery has been increasingly performed for fetal indications. The 15-year interval from 1970 through 1985 saw an unparalleled increase in the cesarean delivery rate, both in the USA and elsewhere, with the rate in the USA temporarily peaking at 24.4% in 1987. The ensuing 15-year interval saw a stabilization of this rate (down to 20.6% in 1996), in large part as a result of efforts to encourage vaginal birth following previous cesarean delivery. The first decade of the 21st century has again witnessed a progressive increase in the cesarean delivery rate, primarily as a result of evolving pressures against vaginal birth following previous cesarean delivery in community hospitals and an increasing frequency of vaginal birth following previous cesarean delivery for failure to make adequate progress in labor [5]. An additional factor, the performance of vaginal birth following previous cesarean delivery on demand, has become more widespread since its endorsement by the American College of Obstetricians and Gynecologists. The most recent US vaginal birth following previous cesarean delivery rate available at the time of this writing is 32%, a 53% increase from 1996.