Editing Caesarean section (section)

===Prevention of complications===

Postpartum infection is one of the main causes of maternal death and may account for 10% of maternal deaths globally.<ref name="Kassebaum-2014">{{cite journal | vauthors = Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al | title = Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013 | journal = Lancet | volume = 384 | issue = 9947 | pages = 980–1004 | date = September 2014 | pmid = 24797575 | pmc = 4255481 | doi = 10.1016/S0140-6736(14)60696-6 }}</ref><ref name="NICE2011" /><ref name=pmid25350672>{{cite journal | vauthors = Smaill FM, Grivell RM | title = Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section | journal = The Cochrane Database of Systematic Reviews | volume = 2014 | issue = 10 | pages = CD007482 | date = October 2014 | pmid = 25350672 | pmc = 4007637 | doi = 10.1002/14651858.CD007482.pub3 }}</ref> A caesarean section greatly increases the risk of infection and associated morbidity, estimated to be between 5 and 20 times as high, and routine use of antibiotic prophylaxis to prevent infections was found by a [[meta-analysis]] to substantially reduce the incidence of febrile morbidity.<ref name=pmid25350672/> Infection can occur in around 8% of women who have caesareans,<ref name=NICE2011 /> largely [[endometritis]], [[urinary tract infections]] and wound infections. Preventative antibiotics in women undergoing caesarean section decreased wound infection, endometritis, and serious infectious complications by about 65%.<ref name=pmid25350672/> Side effects and effects on the baby are unclear.<ref name=pmid25350672/>

Women who have caesareans can recognize the signs of fever that indicate the possibility of wound infection.<ref name=NICE2011 /> Taking antibiotics before skin incision rather than after [[cord clamping]] reduces the risk for the mother, without increasing adverse effects for the baby.<ref name=NICE2011 /><ref name="MackeenPackard2014">{{cite journal | vauthors = Mackeen AD, Packard RE, Ota E, Berghella V, Baxter JK | title = Timing of intravenous prophylactic antibiotics for preventing postpartum infectious morbidity in women undergoing cesarean delivery | journal = The Cochrane Database of Systematic Reviews | issue = 12 | pages = CD009516 | date = December 2014 | pmid = 25479008 | doi = 10.1002/14651858.CD009516.pub2 | doi-access =  | pmc = 11227345 }}</ref> Moderate certainty evidence suggests that [[Chlorhexidine Gluconate|chlorhexidine gluconate]] as a skin preparation is slightly more effective in the prevention of surgical site infections than [[povidone-iodine]] but further research is needed.<ref>{{cite journal | vauthors = Hadiati DR, Hakimi M, Nurdiati DS, Masuzawa Y, da Silva Lopes K, Ota E | title = Skin preparation for preventing infection following caesarean section | journal = The Cochrane Database of Systematic Reviews | volume = 2020 | issue = 6 | pages = CD007462 | date = June 2020 | pmid = 32580252 | pmc = 7386833 | doi = 10.1002/14651858.CD007462.pub5 }}</ref>

Some doctors believe that during a caesarean section, mechanical [[cervical dilation]] with a finger or forceps will prevent the obstruction of blood and [[lochia]] drainage, and thereby benefit the mother by reducing the risk of death. The evidence {{As of|2018|lc=y}} neither supported nor refuted this practice for reducing postoperative morbidity, pending further large studies.<ref>{{cite journal | vauthors = Liabsuetrakul T, Peeyananjarassri K | title = Mechanical dilatation of the cervix during elective caeserean section before the onset of labour for reducing postoperative morbidity | journal = The Cochrane Database of Systematic Reviews | volume = 8 | issue = 8 | pages = CD008019 | date = August 2018 | pmid = 30096215 | pmc = 6513223 | doi = 10.1002/14651858.CD008019.pub3 }}</ref>

[[Hypotension]] (low blood pressure) is common in women who have spinal anaesthesia; intravenous fluids such as [[crystalloids]], or compressing the legs with bandages, stockings, or inflatable devices may help to reduce the risk of hypotension but the evidence is still uncertain about their effectiveness.<ref>{{cite journal | vauthors = Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS, Simmons SW, Cyna AM | title = Techniques for preventing hypotension during spinal anaesthesia for caesarean section | journal = The Cochrane Database of Systematic Reviews | volume = 2020 | issue = 7 | pages = CD002251 | date = July 2020 | pmid = 32619039 | pmc = 7387232 | doi = 10.1002/14651858.CD002251.pub4 }}</ref>