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Semin Perinatol. 2012 Oct;36(5):328-35. doi: 10.1053/j.semperi.2012.04.015.

When is primary cesarean appropriate: fetal indications.

Author information

  • Department of Obstetrics and Gynecology, Columbia University Medical Center, NY 10032, USA. ls731@columbia.edu

Abstract

The objective of this review was to assess the evidence that supports cesarean delivery for fetal indications. The main fetal reasons for abdominal delivery include abnormal fetal heart rate patterns in labor, malpresentation, fetal macrosomia, multiple gestation, and both functional and structural fetal abnormalities. Although the level of evidence is not as strong as anticipated, there is sufficient support for cesarean delivery when these fetal conditions complicate pregnancy. Efforts to decrease cesarean delivery for fetal indications in the current medicolegal environment will not be easy; however, the development of more sensitive tools to assess fetal well-being in labor and practices to deliver or reduce fetuses in breech presentation at term have the potential for greatest impact on the overall primary cesarean delivery rate.

Copyright © 2012 Elsevier Inc. All rights reserved.

PMID:
23009964
[PubMed - indexed for MEDLINE]
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