CC BY-NC-ND 4.0 · Surg J
DOI: 10.1055/s-0039-3402072
Precision Surgery in Obstetrics and Gynecology
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Classical Cesarean Section

Amano Kan
1  Department of Obstetrics and Gynecology, Center for Perinatal Medicine, Kitasato University School of Medicine, Yoshida Obstetrics and Gynecology Clinic, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
06 February 2020 (online)

  

Abstract

Cesarean section is the most common surgery in obstetrics. Several techniques are proposed according to the indication and the degree of urgency. Usually laparotomy followed by hysterotomy with a low transverse incision is preferable. However, in cases in which it is difficult to access the lower uterine segment, such as that in preterm labor, dense adhesion, placenta previa/accrete a vertical hysterotomy (classical cesarean section) may be needed. Although a smooth and gentle delivery of the fetus is possible through the vertical incision, uterine closure is technically difficult. To decrease the risks of hemorrhage and adhesion, a speedy and skillful technique is mandatory. The most serious risk of vertical incision in the contractile corpus is uterine rupture in the subsequent pregnancy. Therefore, cases of prior classical cesarean section are contraindicated for trial of labor after cesarean section.