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CESAREAN SECTION IN THE WORLD AND CROATIA II. Breech Delivery, Multiple Pregnancy, Sequells to Urogenital and Anal System,Cesarean on Request

Ante Dražančić

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In developed countries exists the high incidence of cesarean sections, among indications the alike participa-tion are the uterine dystocia, breech presentation, birth after previous cesarean section and fetal asphyxia. More and more often the women ask the ’cesarean on request.’ In the paper for breech presentation and for multiple pregnancy the data upon a frequency of cesarean sections are presented, and the comparison between the risk for the children after cesarean section and during vaginal delivery is discussed. The new data regarding the pelvic floor damage during vaginal birth with possibility of anal incontinence are presented too. The right of a woman to ’cesarean on request’ in the context of human rights and of physician’s autonomy is discussed. Conclusion. The vaginal birth of term infant in breech presentation, when the cases with risk factors are excluded, is of neglectable higher risk for a newborn. For preterm infants in breech presen-tation the cesarean section seems to be of benefit, the quality and possibilities of neonatal intensive care unit is the most important factor in VLBW children. There is no definitive evidence regarding the permanent anal sphincter mechanism damage following vaginal birth with permanent anal incontinence. The ’cesarean on request’ has no attestation in Croatian legislative, it is opposite to the autonomy and ethics of medical practice.

Ključne riječi
cesarean section; cesarean on request; breech presentation; anal incontinence

Hrčak ID: 9666



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