Complex Cesarean Section

Abstract

The cesarean section, in principle, is not a complex surgical procedure when compared to many others performed in our specialty. However, there is a complex set of physiological and anatomical elements and circumstances that must interact perfectly to obtain an optimal result. Surgical technique is a factor but is often not the primary determinant of a positive outcome; concomitant circumstances interact in a cesarean section such as obstructed labor, abruptio placenta, morbid invasion of the placenta, previous pelvic infection, chorioamnionitis/endometritis, chronic and acute anemia, inadequate blood or insufficient transfusion capacity, oxytocics, anesthetics, lack of (or lack of appropriate administration of) antibiotics, and trained or motivated personnel. In all these cases, and in many other contexts, less-than-optimal results may occur, even in the face of a perfect surgical technique.