**Acknowledgements**

*Recent Advances in Cesarean Delivery*

highly increasing CS rate worldwide.

are they related to the surgical method.

Today Cragin's opinion "once a Caesarean, always a Caesarean" [23] is proved by

In the last decades, the number of Cesarean Sections increased steadily [24]. One of the reasons is the promoting of Cesarean Section by request of the mother [25]. As a result, more placental implantation pathologies occur [26], and certainly more problems related to scar dehiscence following repeated pregnancies following

The best way to prevent these complications is certainly by reducing the number of Cesarean Sections, mainly at low-risk pregnancies. In our group, it was successfully achieved by asking for a documented second opinion for each non-emergency

When a Cesarean Section is done, it is important to perform the operation in a way

that the full thickness of the uterine wall, as well as its strength, will be preserved. It is important to analyze what are the reasons for uterine wall defects and how

It was shown by Di Spiezio et al. that one or two layers suturing of the uterine wall do not make any difference concerning the incidence of Cesarean scar defects as well as the uterine dehiscence and rate of ruptures in subsequent

Although a second layer did not show any benefit concerning the thickness of

If one or two layers of sutures are not the etiology of dehiscence in subsequent

It is known that sutured muscle tissue will never regain its original strength, in contrary to fibrous tissue. Therefore, the less muscle tissue to be cut the better are

*Rorie* analyzed the histological structure of the uterus and found out that the amount of smooth muscle in the upper third of the cervix is 28%, and in the body of

It means the lower the incision in the uterus, the less damage to the uterine wall. As a result, it is important to incise the urine bladder plica, push the bladder down, and cut the uterine wall as low as possible. This is in contrary to the nowa-

The uterus contracts immediately after delivery, and after a few weeks regains its original size. The sutures cannot contract together with the uterus, and their function is to enhance hemostasis in the first hours. Thereafter, the more stitching material is left the more foreign body reaction occurs which might weaken the scar. Therefore, in order to leave as little suturing material as possible, it is important

Technique of this Cesarean section and advantages was described in earlier

This will result in less suture material left behind. We believe that opening the uterus in the lower segment and suture the uterus with one layer using a big needle

The cesarean scar is a significant risk factor for the following pregnancies and especially deliveries. In this chapter, we discussed the diagnosis, incidence, detection, manifestations, and prognosis of pregnancy and delivery with cesarean scars.

pregnancies, it is important to analyze the relevant reason.

days practice to open the uterus above the plica [30].

publications [31–36] with systematic review of literature [37].

will reduce the scar dehiscence in future pregnancies.

**3. Discussion**

Cesarean Sections.

Cesarean Section.

pregnancies [27].

the uterine wall [28].

the uterus 68.8% [29].

the chances for a stronger scar.

to use big needles as possible [31].

**60**

**4. Conclusions**

The authors would like to sincerely thank Mrs. Maya A. Bessarabova for her inestimable assistance of the manuscript preparation.
