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2015 ; 112
(29-30
): 489-95
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Indications for and Risks of Elective Cesarean Section
#MMPMID26249251
Mylonas I
; Friese K
Dtsch Arztebl Int
2015[Jul]; 112
(29-30
): 489-95
PMID26249251
show ga
BACKGROUND: Rates of cesarean section have risen around the world in recent
years. Accordingly, much effort is being made worldwide to understand this trend
and to counteract it effectively. A number of factors have been found to make it
more likely that a cesarean section will be chosen, but the risks cannot yet be
clearly defined. METHODS: This review is based on pertinent publications that
were retrieved by a selective search in the PubMed, Scopus, and DIMDI databases,
as well as on media communications, analyses by the German Federal Statistical
Office, and guidelines of the Association of Scientific Medical Societies in
Germany (AWMF). RESULTS: The increased rates of cesarean section are thought to
be due mainly to changed risk profiles both for expectant mothers and for their
yet unborn children, as well as an increase in cesarean section by maternal
request. In 1991, 15.3% of all newborn babies in Germany were delivered by
cesarean section; by 2012, the corresponding figure was 31.7%, despite the fact
that a medical indication was present in less than 10% of all cases. This
development may perhaps be explained by an increasing tendency toward risk
avoidance, by risk-adapted obstetric practice, and increasing media attention.
The intraoperative and postoperative risks of cesarean section must be
considered, along with complications potentially affecting subsequent
pregnancies. CONCLUSION: Scientific advances, social and cultural changes, and
medicolegal considerations seem to be the main reasons for the increased
acceptibility of cesarean sections. Cesarean section is, however, associated with
increased risks to both mother and child. It should only be performed when it is
clearly advantageous.
|Adolescent
[MESH]
|Adult
[MESH]
|Attitude to Health
[MESH]
|Cesarean Section/*mortality/*statistics & numerical data
[MESH]
|Elective Surgical Procedures/*methods/*statistics & numerical data
[MESH]
|Evidence-Based Medicine
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Middle Aged
[MESH]
|Patient Acceptance of Health Care/*statistics & numerical data
[MESH]
|Postoperative Complications/*mortality
[MESH]
|Pregnancy
[MESH]
|Pregnancy Outcome/epidemiology
[MESH]
|Prevalence
[MESH]
|Public Opinion
[MESH]
|Risk Assessment/methods/statistics & numerical data
[MESH]