Indications for an emergency caesarian section

The reduced danger of caesarian section has resulted in a tendency to perform surgery on the grounds of foetal distress. Thus, conditions such as placenta praevia, severe maternal hypertension or diabetes, haemolytic disease and prolapse of the cord are all considered to be indications for section.

When deciding on a caesarian section one should weigh the risk to the mother against the potential benefit for the foetus.

In general, the indications for caesarian section are classified as follows:

• faults in the birth canal
• foetal malpresentations
• abnormal uterine action
• antepartum haemorrhage
• miscellaneous maternal indications
• foetal indications

Classification of urgency for caesarean birth

Use the following standardised scheme to document the urgency of caesarean birth and aid clear communication between healthcare professionals:

• Category 1. Immediate threat to the life of the woman or fetus (for example, suspected uterine rupture, major placental abruption, cord prolapse, fetal hypoxia or persistent fetal bradycardia)
• Category 2. Maternal or fetal compromise which is not immediately life-threatening
• Category 3. No maternal or fetal compromise but needs early birth
• Category 4. Birth timed to suit woman or healthcare provider

Reference:

• 1) NICE (March 2021). Caesarian Section