Concept of Caesarean Section (C-section) | Literature Review

Running head: LITERATURE REVIEW
Literature Review
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Background
The concept of the caesarean section (C-section) refers to the method of surgery
during the delivery of a baby and in this process the baby is taken out from the abdomen of
the mother by cutting out the mother’s abdomen. Therefore, it is stated that, a few C-section
surgeries are pre planner and on the other hand in most of the cases this surgery is performed
to manage the emergency situation during the process of delivery (Taha et al. 2019). In this
essay a brief literature review of C-section deliveries is performed.
Review of Literature
Overview of Caesarean sections (cs) and Related Facts
In UAE, the rate of CS has enhanced a lot and it was observed that in the year of 1995
the rate of CS was almost 10 per cent and it touched the amount of 24 per cent in the year of
2014. According to the report of World Health Organization (WHO) it is reported that the
rate of CS in case of all type of live births is almost 10 per cent to 15 per cent that is much
lower than that of the overall CS rate of UAE (Taha et al. 2019). According to the study of
Jasim et al. (2017), it is stated that the consequences of CS is correlated with not only with
the infants but also with the mothers. In this regard it can be stated that the consequences are
mainly associated with problems such as haemorrhage, cystitis, endometritis, respiration
related complications, and hypoglycaemia and it is reported by the researchers that such type
of problems can hamper the breastfeeding practices of the infants. As a result the level of
immunity among the infants is lowered.
Complications of CS
While discussing about the complications of the CS, it can be stated that excessive
bleeding is one of the major problems associated with CS delivery. In this regard it is

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commendable that during the time of active labour almost 20 to 30 per cent of the blood are
supplied to that region and during the CS delivery , the surgeon cuts the uterus and as a result
a huge amount of blood loss is reported (Jido and Garba 2012). In another study by Haas et
al. (2018), it is observed that the amount of blood loss is almost twice in case of CS compared
to normal delivery.
Overview of SSI and Related Risk Factors
Another crucial factor that is associated with the CS among the mothers is the risk of
infection that is Caesarean Surgical Site Infection or SSI. The cases of SSI among the patients
with CS is comparatively higher and in this context, it can be stated that breaching of the skin
or mucosa during the process of CS allows the bacteria and other microbial elements to enter
the blood system and thus the chances of SSI is enhanced among those patients having the
problem of CS (Jalil et al. 2017). According to the study of Zejnullahu et al. (2019), it is
reported that due to CS a wide range of SSI can take place and in most of the cases health
care related infections are reported by the different authors and health care professionals.
Around the world, it is reported that SSI is correlated with the enhanced level of mortality
and morbidity, poor quality of life, prolonged antibiotic treatment. In the study of Jalil et al.
(2017), it is reported that in hospital of Jordan high rate of SSI was found to be very high and
it was detected as 14.4 per cent along with a pregnancy odds ratio (OR) 3.8, 95% confidence
interval (95% CI) 1.6–9.4. In case of patients with more than 3.5 days of hospital stay the OR
was almost 2.3 along with a CI of 1.4-3.6.
Types of CS SSI infection
While discussing about the type of CS infections, it can be stated that there are mainly
two type of CS infection. The first one is host related SSI and the other one is host unrelated
SSI. As a part of host related SSI, the hosts that can create such infection are mainly

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Staphylococcus epidermidis, Escherichia coli, Ureaplasma urealyticum and Enterococcus
faecalis (Jalil et al. 2019).
As per the data, there are mainly three types of SSI and they are Superficial
incisional SSI, Deep incisional SSI and Organ or space SSI. According to the study of
Kawakita and Landy (2017), it is reported that all type of SSI generally occurs within 30 days
of the CS surgery.
Post-discharge surveillance
As a part of the post surveillance strategy for the CS surgery it can be stated that the
main goal is to reduce the risks of infections during post-operative sessions. As a part of this
there are various aspects and they are mainly preoperative, intraoperative, and postoperative
practices. As a part of preoperative strategies, hair removal before the CS surgery can be
applied. According to the study of Zuarez-Easton et al. (2017), it is stated that shaving the
surgical site is highly associated with higher rate of SSI infection compared to clipping due to
microscopic disruptions in the skin caused by the razor. Another preventive measure of post-
operative management of SSI is skin preparation and in a study it was reported that use of
alcohol with chlorhexidine compared to povidone–iodine with alcohol for skin antisepsis has
been proven to be successful in skin preparation before the CS surgery. The use of
chlorhexidine–alcohol caused in an expressively lesser risk of complete SSI (4.0%) after CS
compared to iodine–alcohol (7.3%).
Vaginal Preparation
The vaginal preparation is one of the management of part of SSI following CS.
Therefore, it can be stated that it is one of the most crucial post-surgery management
technique of those who have undergone the process of CS (Haas et al. 2014). In the study of