Preface

A cesarean section is a life-saving surgical procedure when certain complications arise during pregnancy and labor. *Recent Advances in Cesarean Delivery* is a collection of research chapters on cesarean delivery and related developments within the field of obstetrics. Written by experts in the field, chapters cover such topics as prediction of cesarean delivery, hemostasis for massive hemorrhage during C-section, maternal and fetal risks, cesarean scar defect manifestations, obesity and C-section, and C-sections in low-, middle-, and high-income countries.

**IntechOpen**

**1**

**Chapter 1**

**Abstract**

*and Naomi Burke*

management plan for each woman.

**1. Introduction**

delivery [2].

Prediction of Caesarean Delivery

For expectant parents, a first birth is notable for its unpredictability, and the path to safe labour and delivery is commonly complicated by a requirement for unplanned caesarean delivery. The ability to anticipate an uncomplicated vaginal birth, or to predict the requirement for unplanned caesarean delivery, carries the potential to facilitate optimal birth choices. For example, elective caesarean delivery confers substantially less risk than unplanned caesarean delivery performed during the course of labour. Pre-delivery knowledge of a high predictive risk of requiring intrapartum caesarean delivery could lead to women opting to deliver by elective caesarean delivery, thereby lowering associated risks. Equally, pre-labour knowledge of a high prospect of achieving a successful and uncomplicated vaginal birth could result in enhanced motivation for women to deliver in a less medicalised environment. Predictive risk models have been utilised to good effect in other areas of medicine. The incorporation of a risk predictive tool for intrapartum caesarean delivery would enable women and their caregivers to choose the most appropriate

*Niamh C. Murphy, Fionnuala M. Breathnach* 

**Keywords:** prediction model, caesarean delivery, personalised care

The last three decades have witnessed an escalation in global Caesarean section rates. It is well recognised that there is an association between delivery by Caesarean

advanced stage in labour [1]. This association is significantly stronger in the setting of emergency Caesarean section than scheduled elective non-labour Caesarean delivery. It is notable that post-operative complications, including haemorrhage and perioperative infection in women who undergo unplanned Caesarean delivery are significantly higher when compared to women who undergo elective Caesarean

Magann et al. [3] examined the outcomes regarding post-partum haemorrhage of over 4000 Caesarean section deliveries in Australia in their observational study. They determined that the incidence of post-partum haemorrhage in an emergency

A 2014 Cochrane review [4] examined the rates of post-partum sepsis for both intrapartum and elective caesarean sections. They identified 95 studies, which recruited over 15,000 women. They determined that the rates of wound infection were 9.7 and 6.8% respectively. As regards endometritis, the rates were 18.4% for intrapartum caesarean sections versus 3.9% for elective caesarean sections.

section and both short and long-term maternal morbidity, particularly at an

setting was 6.75% and the incidence in an elective setting was 4.74%.
