[Development of indications for cesarean section in the Czech Republic and certain developed countries].

The author analyzes the reasons for the rapid increase of pregnancies terminated by caesarean section; in some countries (USA, Canada and others) the frequency is as high as 20%. The main reason was a change of indication for caesarean section: not only hazard to the mother, but above all hazard to the foetus. It seems however that there is no relationship between the frequency of caesarean and the level of perinatal mortality. On the contrary, in many instances caesarean section increases the risk of mother and foetus and the neonate. In the Czech Republic the rate of caesarean sections was 7.8%: the main indications were the hazard of foetal hypoxia and an unfavourable presentation of the foetus. Some non-obstetric indications play a part: in particular orthopaedic and ophthalmological ones: they are the indication for every tenth caesarean section. In multiple pregnancies (in our country 42% are terminated by caesarean section), in particular pathological presentations of the foetus are involved. So far efforts of the international obstetric organization to reduce the use of caesarean section did not prove very successful.