**3.2 Foetal indications**


**89**

system including:

*Caesarean Section in Low-, Middle- and High-Income Countries*

15.Some individuals also consider caesarean delivery for certain congenital

2.Abnormal placentation (e.g. placenta praevia, vasa praevia, placenta

There are no absolute contraindications to caesarean delivery. In contrast to other types of surgery, the risks and benefits of the procedure need to be considered as they apply to two patients. However, many pregnant women have a low tolerance for accepting any foetal risk from vaginal birth, irrespective of the maternal risks

Traditionally, caesarean section has been classified as emergency or elective. However, with advanced practice in obstetrics and more complicated deliveries encountered, this definition has become too simplistic, and more detailed categories are needed. Some authors have also suggested that the term "elective caesarean delivery" should probably be eliminated because a caesarean delivery is either "medically/obstetrically indicated" or "on maternal request" and never truly "elective" [8]. Such authors advocate for terms as *scheduled or planned* caesarean delivery in which the decision to perform an indicated caesarean delivery may be made antepartum and *unscheduled or unplanned* caesarean section where decision to perform an indicated caesarean delivery is made as a result of concerns identified after labour has begun. The decision to perform an unscheduled caesarean section may also arise even when labour has not occurred such as in abruption placentae with a live baby and no labour pains or absent foetal movement with abnormal

Also distinguishing between prelabour caesarean section (which may be sched-

uled/elective or emergency/unscheduled) and intrapartum caesarean delivery

Lucas and colleagues [15] developed the classification of caesarean delivery based on urgency approved by the Royal College of Obstetricians and

Gynaecologists (RCOG) and the Royal College of Anaesthetists in the UK after it was developed further into the most consistent method recommended by National

The initial classification by Lucas et al. [15] was a four-grade classification

anomalies (e.g. open neural tube defects, some skeletal dysplasia and gastro-

*DOI: http://dx.doi.org/10.5772/intechopen.88573*

schisis with herniated liver) [11, 12].

**3.3 Both maternal and foetal indications**

accreta)[3].

3.Obstructed labour.

4.Cephalopelvic disproportion.

5.Failed operative vaginal delivery [8].

associated with operative intervention [13].

**4. Classification of caesarean section**

umbilical artery Doppler studies not in labour.

(which is, by default, emergency) is preferable [14].

Confidential Enquiry into Perioperative Deaths [16].

6.Abruption placenta with a live baby [9].

1.Failure to progress during labour [1].

15.Some individuals also consider caesarean delivery for certain congenital anomalies (e.g. open neural tube defects, some skeletal dysplasia and gastroschisis with herniated liver) [11, 12].
