Caesarean section: techniques and complications

One-fifth of deliveries in England and Wales are undertaken by caesarean section. The procedure has changed very little over the years, although evidence-based refinements have resulted in reduced morbidity; research continues in adapting techniques to improve safety further. Preoperative preparation involving anaesthetists and radiologists if complications are anticipated has contributed to improved outcome. Good surgical training is paramount, particularly because trainee doctors undertake many of the emergency procedures. Surgical techniques (including manoeuvres that may help in difficult situations) and surgical complications are discussed. Guidance from the UK National Institute for Health and Clinical Excellence on caesarean section has allowed more accurate counselling on risks and benefits, although difficulties remain.