A recently reviewed study confirms that performing caesarean section carries risks for maternal and baby health and that it should only be practiced in cases of urgency and necessity, when they are really necessary, and can even save lives.
For this, data from more than 97,000 deliveries in 120 hospitals (public and private) in eight Latin American countries have been taken into account.
Fetal, maternal or neonatal mortality (up to hospital discharge) and maternal or neonatal morbidity associated with birth by elective caesarean section (caesarean section indicated before the onset of labor), intrapartum caesarean section (caesarean section indicated after onset of birth, were taken into account) spontaneous or induced) or vaginal.
Is about a very complete study which takes into account different types of delivery, the conditions in which the caesarean section is performed and the maternal risk factors.
Caesarean sections by urgent indication, multiple gestations and cases with incomplete birth data were excluded. Varied maternal risk factors were also taken into account (age under 16 or over 35 years, primiparity, previous caesarean section, abortions or previous neonatal mortality, history of uterine surgery ...).
Possible confounding factors included referral of the pregnant woman to hospital, induced labor or epidural anesthesia during labor.
Results of the study on caesarean sections
The main results found an increased risk of maternal morbidity and mortality in cesarean deliveries compared to vaginal births.
When analyzing fetal mortality, elective caesarean section in deliveries with a cephalic presentation discreetly decreased mortality in relation to vaginal delivery, and both elective and intrapartum caesarean sections decreased fetal mortality in podtal presentation in relation to vaginal delivery.
The research findings indicate that the globally considered caesarean section implies an increased risk of maternal morbidity and mortality with respect to vaginal delivery.
So when would the intervention be justified? According to your data, in deliveries with podic presentation Caesarean section reduces the risk of fetal mortality and neonatal morbidity and mortality. Reviewers of the study point out that there is a protective effect on fetal mortality that has cesarean delivery in breech presentations, already described in previous studies.
In deliveries with cephalic presentation, although it could reduce the risk of fetal death, both the risk of maternal and neonatal morbidity and mortality increases.
As we often see and report on our pages, the increase in the number of cesarean deliveries without medical indication has no justification, and the real risks of such an intervention should be taken into account.
All those involved, especially doctors, who must objectively inform mothers and relatives, but also these, should weigh these risks before opting for an unnecessary caesarean section.
