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Archives of Gynecology and Obstetrics

, Volume 298, Issue 1, pp 9–16 | Cite as

Non-obstetrical indications for cesarean section: a state-of-the-art review

  • Roberta Venturella
  • Paola Quaresima
  • Mariella Micieli
  • Erika Rania
  • Annarita Palumbo
  • Federica Visconti
  • Fulvio Zullo
  • Costantino Di Carlo
Review

Abstract

Purpose

To propose an evidence-based review on the most frequent indications for Cesarean section (CS) given by specialists in disciplines other than Obstetrics and Gynecology, with the aim of increasing consciousness about the available data in the literature and the guidelines recommendations about topics that are not frequently managed by obstetricians and gynecologists.

Methods

We analyzed hospital discharge data regarding deliveries occurred in a 10-year study period in our department to obtain the prevalence and the list of the most recurrent non-obstetrical indications for CS. A search was performed in PubMed, the Cochrane Library, SCOPUS, Web of Science and Ovid MEDLINE and only studies published in English from 1950 to 2017 were included. For indications for which no systematic reviews existed, we included the best available evidence, including guidelines of non-obstetrics scientific societies or organizations, RCTs, non-randomized controlled clinical trials, case–control studies, cohort studies, and case series.

Results

The rising rate of CS registered in the recent years is not justified by reduction in maternal––fetal risk or perinatal outcomes and often reflects inappropriate clinical behaviour and a wrong tendency that assimilates CS as a defensive practice. In a relevant percentage of cases, the indication to CS is given by specialists in other disciplines, even when specific guidelines do not give clear recommendation about the route of delivery.

Conclusions

To refuse non-obstetrical indications for CS, when scientific support is lacking, could be a useful and safe strategy to further reduce the rate of unnecessary CS.

Keywords

Cesarean section Delivery Indication for cesarean section Vaginal delivery Maternal conditions 

Notes

Author contributions

RV: Protocol/project development, data analysis, manuscript writing/editing. PQ: Data collection or management, data analysis. MM: Data collection or management, data analysis. ER: Data collection or management, data analysis. AP: Data collection or management, data analysis. FV: Data collection or management, data analysis. CDC: Manuscript writing/editing. FZ: Manuscript writing/editing.

Compliance with ethical standards

Funding

This study was not funded by anyone.

Conflict of interest

The authors report no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology“Magna Grecia” UniversityCatanzaroItaly

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