Foetal indications

Diabetes mellitus:

• poorly controlled maternal diabetes results in complications such as macrosomia, polyhydramnios and pre-eclampsia
• affected babies are often delivered by caesarian section

Placental insufficiency:

• this is suggested by a "small-for-dates" foetus, maternal hypertension, proteinuria and/or previous foetal death
• the first line of treatment is by attempted induction of labour. Failing this a caesarian section is indicated

Foetal distress:

• foetal distress is more common in postmature foetuses and in prolonged labour
• distress is assessed by monitoring the foetal heart rate and by foetal scalp blood sampling

Prolapse of the cord:

• a caesarian section should be performed if the cervix is insufficiently dilated to permit immediate vaginal delivery

Bad obstetric history:

• repeated stillbirths and neonatal deaths may be an indication for section

Old primigravida:

• section for the older woman is not routine but one is more inclined to intervene when minor complications arise

Gross prematurity:

• between weeks 26 to 32 the foetus is prone to intracranial haemorrhage
• this may be avoided by caesarian section