Cesarean Delivery by R. Salim

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By R. Salim

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376, (July 1986), pp. 321-340, ISSN 1469-7793. , Gissler, M. (2008). Severe maternal morbidity and the mode of delivery. 6, (June 2008), pp. 662-668, ISSN 1600-0412. , & Chiwel, Y. (1993). Pulmonary gas exchange immediately after birth in spontaneously breathing infants. 68, No. 1, (January 1993), pp. 6-10, ISSN 1468-2044. , & Berger, PJ. (2001). Volume and secretion rate of lung liquid in the final days of gestation and labor in the fetal sheep. Pt3, (September 2001), pp. 889-899, ISSN 1469-7793.

Until prospective randomized trials are conducted, it is not easy to precisely answer all risk:benefit questions as to the best timing of when to schedule elective cesarean delivery; 38 or 39 weeks. Since several studies indicated that neonatal outcomes are improved by delaying cesarean until 39 weeks of gestation, the American College of Obstetricians and Gynecologists as well, recommended delaying cesarean delivery until 39 weeks of gestation in the absence of obstetric or medical indications for early delivery.

Gastric content values of volume and pH, and competence of lower esophageal tone play major role in the occurrence of aspiration. 5 and a volume greater than 25 ml of stomach contents. 4 ml/kg. Certain factors contribute to the risk of aspiration in parturients. Although it has been contentious as to whether gastric emptying and gastric pH are decreased throughout pregnancy, it is well known that gastric emptying is delayed during labor and delivery. In addition, anatomic changes resulting from displacement of the stomach by the pregnant uterus and decreased lower esophageal sphincter tone, caused by increased progesterone levels, produce an increased incidence of gastroesophageal reflux in the pregnant woman.

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