caesarian section and repeated caesarian section

definition of caesarian section it is a surgical procedure in which one or more incisions are made through a mother's abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies, or, rarely, to remove a dead .fetus The indication: 1- prolonged labour or a failure to progress (dystocia) 2- fetal distress 3- cord prolapse 4- uterine rupture 5- increased blood pressure (hypertension) in the mother or baby after amniotic rupture 6- increased heart rate (tachycardia) in the mother or baby after amniotic rupture 7- placental problems (placenta praevia, placental abruption or placenta accreta) 8- abnormal presentation (breech or transverse positions) 9- failed labour induction 10failed instrumental delivery (by forceps or ventouse (Sometimes a trial of forceps/ventouse delivery is attempted, and if unsuccessful, it will be switched to a Caesarean section.) 11large baby weighing >4000g (macrosomia)

12umbilical cord abnormalities (vasa previa, multilobate including bilobate and succenturiate-lobed placentas, velamentous insertion) 13abnormal presentation

Other complications of pregnancy, pre-existing conditions and concomitant disease, such as: 1- pre-eclampsia 2- hypertension 3- multiple births 4- previous (high risk) fetus 5- HIV infection of the mother 6- Sexually transmitted infections, such as genital herpes 7- previous classical(longitudinal) Caesarean section 8- previous uterine rupture 9- prior problems with the healing of the perineum (from previous childbirth or Crohn's disease) 10Bicornuate uterus

11Rare cases of posthumous birth after the death of the mother types of Caesarean section: according to the type of incision (longitudinal or latitudinal) :Anaesthetic for a caesarean section 1. Spinal anaesthetic

2. Epidural anaesthetic 3. General anaesthetic

repeated caesarian section although there isn't enough research to support a specific limit on repeat C-sections, most women can safely have up to three cesarean deliveries. Each repeat C-section is generally more complicated than the last. The risk: 1- surgical complications as infection or heavy bleeding 2- Problems with the placenta as (placenta previa) 3- Weakened uterine wall 4- Bladder injuries.