An evaluation of cesarean section.

The risks of cesarean section have been reduced in step with the increase in safety of all major surgical procedures. In a series of 13,153 deliveries, 1,265 (9.6 per cent) were by cesarean section. There were three obstetrical maternal deaths in 11,888 cases in which delivery was by the vaginal route-0.025 per cent. In the series of 1,265 deliveries by cesarean section there was one death attributable to the operation-0.08 per cent. The total uncorrected fetal loss following cesarean section was 3.8 per cent. This compares favorably with fetal loss of 3.2 per cent in the vaginal delivery group in this series, and with fetal loss rates reported from large obstetrical centers. Anesthesia by spinal injection is the method of choice in cesarean section. There were no maternal deaths or accidents attributable to spinal anesthetic, and in no case was it felt that fetal death was attributable to it. The incidence of maternal morbidity in the cesarean section group following spinal anesthesia was 15.8 per cent-less than half the incidence of morbidity following inhalation anesthesia.