GYN CHRONICLES
CAESEREAN SECTION
By Dr. Maureen Owiti
I
have been doodling and agonizing
on what to write about in my
maiden column and finally got
inspiration from a discussion we
recently had about Caeserean Sections
(CS). I would like this column to be
interactive so if you have any issues or
questions don’t hesitate to ventilate
I will respond individually and in
subsequent issues.
So what is this animal called a
Caeserean Section? Put simply it’s an
operation that involves making a cut
on the lower abdomen or belly and
uterus to deliver the baby. Historically
people think the name is derived from
the birth of Julius Caesar via CS but
as his mother survived the operation
it’s unlikely that was the case.
A CS was a death sentence to the
mother until recent improvements
in healthcare such as Flemming’s
great innovation penicillin and a new
bright era of antibiotics plus, all the
wonderful things done by my favorite
colleagues anaethesiologists together
with pharmacologists, made it safe.
Worldwide, figures for 2013 show that
approximately 23 million Caesars are
performed annually. These figures are
mind blowing so it means practically
if you haven’t had a CS yourself you
should at least know someone who
has had one.
Why do we perform Caeserean
Sections?
Well a very interesting question!
Remember when we have an expectant
mum issues can arise in her, her
baby, the placenta or there could be a
problem with the progress of her labor.
“Why do we perform Caeserean Sections? Well
a very interesting question! Remember when
we have an expectant mum issues can arise in
her, her baby, the placenta or there could be a
problem with the progress of her labor.”
66 MAL 11/16 ISSUE
The most common cause of CS is
Cephalo-Pelvic Disproportion CPD. Basically this is when either
the mother’s pelvis is smaller than
expected so a normal sized baby
cannot pass through her birth canal
or the baby is just too big: Those
wonderful 4000g and above babies we
are now having as first time mums.
It’s noteworthy that all first time
mums are put through a trial of labor.
Previously we would check the pelvis
and conclude that the woman cannot
have a vaginal birth but a fantastic
study performed in South Africa
proved that this strategy was not good
as a good number of women who
would have been labeled as being
CPD (small pelvis) delivered vaginally
and others who should have had
vaginal deliveries and were not CPD
ended up with a CS.
Another common reason is an
abnormal presentation or lie such
as breech or transverse lie. Breech
is when the baby is coming legs or
buttocks first instead of the baby’s
head and transverse is when the baby
is lying across the uterus and if labor
progresses an arm prolapse can occur.