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Shmakov R.G.

V.I. Krasnopolsky Moscow Regional Scientific Research Institute of Obstetrics and Gynecology;
M.F. Vladimirsky Moscow Regional Scientific Research Institute

Novikova S.V.

V.I. Krasnopolsky Moscow Regional Scientific Research Institute of Obstetrics and Gynecology;
M.F. Vladimirsky Moscow Regional Scientific Research Institute

Il’yashenko E.N.

N.I. Pirogov Russian National Research Medical University

Logutova L.S.

V.I. Krasnopolsky Moscow Regional Scientific Research Institute of Obstetrics and Gynecology;
M.F. Vladimirsky Moscow Regional Scientific Research Institute

Cesarean section in modern obstetrics: problems and ways to overcome them

Authors:

Shmakov R.G., Novikova S.V., Il’yashenko E.N., Logutova L.S.

More about the authors

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To cite this article:

Shmakov RG, Novikova SV, Il’yashenko EN, Logutova LS. Cesarean section in modern obstetrics: problems and ways to overcome them. Russian Bulletin of Obstetrician-Gynecologist. 2025;25(4):5‑18. (In Russ.)
https://doi.org/10.17116/rosakush2025250415

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References:

  1. Il’yin N. Statistics of cesarean section in Russia: How often do people give birth by caesarean section in Russia. Tinkoff magazine. WHO, Statista. Statistics 06.03.23 8K. (In Russ.). https://journal.tinkoff.ru/stat-kesarevo/
  2. Krasnopol`skii VI, Radzinskii VE, Logutova LS, Buyanova SN, Aksenov AN, Upryamova EYu, Mel`nikov AP, Puchkova NV. Cesarean section. Problems of abdominal obstetrics: a guide for physicians. Ed. VI Krasnopol`skii. Moscow: SIMK. 2018;224. (In Russ.).
  3. World Health Organization. WHO Statement on Caesarean Section Rates. WHO/RHR/15.02; 2015.
  4. Betran AP, Ye J, Moller AB, Zhang J, Gulmezoglu AM, Torloni MR. The Increasing trend in caesarean section rates: Global, regional and national estimates: 1990-2014. PLoS One. 2016;11: 2:e0148343. https://doi.org/10.1371/journal.pone.0148343
  5. Boyle A, Reddy UM. Epidemiology of cesarean delivery: the scope of the problem. Semin Perinatol. 2012;36:5:308-314.  https://doi.org/10.1053/j.semperi.2012.04.012
  6. Souza JP, Gulmezoglu A, Lumbiganon P, Laopaiboon M, Carroli G. Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: the 2004-2008 WHO global survey on maternal and perinatal health. BMC Med. 2010;8:71.  https://doi.org/10.1186/1741-7015-8-71
  7. Ulla S, Beisenova A. Factors contributing to an increase in the frequency of cesarean section: a literature review. Reproduktivnaya meditsina. 2022;4:53:68-75. (In Russ.). https://doi.org/10.37800/RM.3.2022.68-75
  8. Robson M. Classification of caesarean section. Fetal Maternal Med Rev. 2001;12:23-39.  https://doi.org/10.1017/S0965539501000122
  9. Robson M, Hatrigan L, Murphy M. Methods of achieving and maintaining an appropriate caesarean section rate. Best Pract Res Clin Obstet Gynaecol. 2013;27:2:297-308.  https://doi.org/10.1016/j.bpobgyn.2012.09.004
  10. Souter V, Jodie K, Chien A. The Robson classification: Monitoring and comparing cesarean delivery rates. Obstet Gynecol. 2016;127:131.  https://doi.org/10.1097/01.AOG.0000483531.18218.6d
  11. Lebedenko EYu, Bespalaya AV, Feoktistova TE, Rymashevskii MA. Analysis of global trends in caesarean section rates using the Robson classification. Meditsinskii vestnik Yuga Rossii. 2021;12:2:16-21. (In Russ.). https://doi.org/10.21886/2219-8075-2021-12-2-16-21
  12. Guryev DL, Okhapkin MB, Gur’eva MS, Kabanov IV, Gur’eva DD, Asadova SA. Reduction of the frequency of cesarean section and perinatal losses in a level 3A hospital using the Robson classification. Doctor. Ru. 2019;4:159:8-13. (In Russ.). https://doi.org/10.31550/1727-2378-2019-159-4-8-13
  13. Shabalov NP, Schmidt AA, Gaivoronskikh DI, Bezmenko AA, Ivanova LA, Tikhonova TK, Fedorova LA. Perinatology: textbook for students of medical universities. St.-Petersburg: SpecLit. 2020;206. (In Russ.).
  14. Pavlova NG. Actual problems of perinatology — the results of 20 years of research at the Laboratory of Fetal Physiology and Pathophysiology. Zhurnal akysherstva i zhenskikh boleznei. 2010;LIX:1:51-56. (In Russ.).
  15. Baibarina EN, Degtyarev DN. Perinatal medicine: from theory to practice. Rossiiskii vestnik perinatologii i pediatrii. 2013;58:5:4-7. (In Russ.). https://cyberleninka.ru/article/n/perinatalnaya-meditsina-ot-teorii-k-ptaktike
  16. Krasnopol’skii VI, Petrukhin VA, Logutova LS, Baev OR, Shmakov RG, Filippov OS, Adamyan LV, Mel’nikov AP, Smol’nova TYu. Provision of specialized care during operative vaginal delivery in the presence of a live fetus (using obstetric forceps or using a vacuum extractor or delivery using another obstetric aid). Clinical recommendations (treatment protocol). Moscow. 2017;34. (In Russ.).
  17. Tanaka K, Mahomed K. The Ten-Group Robson Classification: A Single center approach identifying strategies to optimise caesarean section rates. Obstet Gynecol Int. 2017;2017:5648938. https://doi.org/10.1155/2017/5648938
  18. Radzinskii VE, Kostin IN, Lavrova NYu. Intranatal risk factors and neonatal outcomes. Vtstnik novykh meditsinskikh tekhnologii. 2010;4:XVII:130-131. (In Russ.).
  19. Michel’ Oden. Caesarean section: A safe way out or a threat to the future? Moscow: International School of Traditional Obstetrics. 2006;216. ISBN: 5-9900577-1-7 (In Russ.). https://libking.ru/books/home-/home-health/76282-mishel-oden-kesarevo-sechenie-bezopasnyy-vyhod-ili-ugroza-budushchemu,html
  20. Pelvic presentation of the fetus. Clinical recommendations. 2023;51. 
  21. Makogon AV, Andryushina IV. External obstetric turn. Clinical case demonstration and literature review. Ural’skii meditsinskii zhurnal. 2013;8:113:13-18. 
  22. Hussin OA, Mahmoud MA, Abdel-Fattah MM. External cephalic version for breech presentation at term: predictors of success, and impact on the rate of caesarean section. East Mediterr Health J. 2013;19:2:162-166. 
  23. Cho LY, Lau WL, Lo TK, Tang HH, Leung WC. Predictors of successful outcomes after external cephalic version in singleton term breech pregnancies: a nine-year historical cohort study. Hong Kong Med J. 2012;18:1:11-19. 
  24. Burgus J, Meichor JC, Pijobn JI, Cobos P, Fernandez-Liebrez L, Marthnez-Astorquiza T. A prospective study of the factors associated with the success rate of external cephalic version for breech presentation at term. Int J Gynaecol Obstet. 2011;112:1:48-51. 
  25. Obeidat N, Lataifeh I, Al-Khateeb M, Zayed F, Khriesat W, Amarin Z. Factors associated with the success of external cephalic version (ECV) of breech presentation at term. Clin Exp Obstet Gynecol. 2011;38:4:386-389. 
  26. Kok M. Risk of developmental dysplasia of the hip in breech presentation: the effect of successful external cephalic version. BJOG. 2013;120:607-612. 
  27. Musaev OKh, Musaeva KO, Radzhabova ShSh. Obstetric and perinatal aspects of pelvic presentation of the fetus depending on the tactics of pregnancy and childbirth. Russian Bulletin of Obstetrician-Gynecologist. 2010;10:4:32-34. (In Russ.).
  28. Obstetrics: National guide. Ed. by EK Ailamazyan, VI Kulakov, VE Radzinskii, GM Savel’eva. Moscow: GEOTAR-Media. 2009;988-996. (In Russ.).
  29. Gaidukov SN, Klyus OS, Reznik VA, Vasil’ev VV. Should preventive rotation in pelvic presentation of the fetus become a generally accepted practice. Zhurnal akusherstva i zhenskikh boleznei. 2007;LVI:2:105-110. (In Russ.).
  30. Chernukha EA, Puchko TK. Pelvic presentation of the fetus. Moscow: GEOTAR-Media. 2007;101-129. (In Russ.).
  31. Shramko S.V., Leonova E.S., Alekseeva M.V. External obstetric rotation of the fetus. Mat’ i ditya v Kuzbasse. 2024;1:96:97-100. (In Russ.).
  32. Obstetrics: national guidelines. Ed. by GM Savel’eva, GT Sukhikh, VN Serov, VE Radzinskii. Moscow: GEOTAR-Media. 2015. (In Russ.).
  33. Dudareva YuA, Antonova SA, Zhivet’eva NV. External rotation of the fetus on the head in modern obstetrics: effectiveness and safety assessment. Russian Bulletin of Obstetrician-Gynecologist. 2023;23:6:162-166. (In Russ.). https://doi.org/10.17116/rosakush202323062162
  34. Lyalichkina NA, Peshev LP. The effectiveness of cervical preparation and induction of birth with mifepristone. Sovremennye problemy nauki i obrazovaniya. 2015 6:35-45. (In Russ.).
  35. Khvorostukhina NF, Leonova AM, Novichkov DA, Yatsenko DS. The experience of using mifepristone in the preparation of the cervix for childbirth during full-term pregnancy. Sovremennye problemy nauki i obrazovaniya. 2016;1:23-31. (In Russ.).
  36. Pekarev OG, Brega ES, Lun’kov SS, Gus AI. Clinical and elastographic assessment of options for preparing an immature cervix for childbirth. Doctor.ru 2019;166:11:22-28. (In Russ.). https://doi.org/10.31550/1727-2378-2019-166-11-22-28
  37. Shaposhnikova EV, Dikke GB, Bazina MI, Tskhai VB, Egorova AT, Mentsik MM, Tsaryuk EP, Zhirova NV. Comparative assessment of mechanical methods of preparing the cervix for childbirth in pregnant women with extragenital diseases. Akusherstvo i ginekologiya. 2020;8:88-94. (In Russ.). https://doi.org/10.18565/aig.2020.8.88-94
  38. Brega ES, Pekarev OG, Gus AI, Lun’kov SS. Clinical and elastographic assessment of options for the preparation of an “immature” cervix. Akusherstvo i ginekologiya. 2019;10:81-91. (In Russ.). https://doi.org/10.18565/aig.2019.10.81-91
  39. Clinical recommendations. Unsuccessful attempt to stimulate labor (preparation of the cervix for childbirth and labor induction). 2021; 61. (In Russ.)
  40. Vlasiuk VV. Circulatory intranatal hypoxia. Russian Journal of Archive of Pathology. 2019;81:4:73-77. (In Russ.). https://doi.org/10.17116/patol20198104173
  41. Obstetrics. National guide. Ed. EK Ailamazyan, VI Kulakov, VE Radzinskii, GM Savel`eva. Moscow: GEOTAR-Media Publ. 2014. (In Russ.).
  42. Yur`ev SYu, Mustafina LR, Nemtseva TN, Kiiko YaV, Mikheenko GA. Promising ways to assess the condition of the fetal cardioregulatory system. Fundamental`nye issledovaniya. 2014;10-9:1840-1843. (In Russ.).
  43. Medvedeva IN, Davydova AV. The optimal choice of diagnosis of fetal hypoxia in childbirth. Russian Bulletin of Obstetrician-Gynecologist. 2021;21:4:54-60.  https://doi.org/10.17116/rosakush20212104154
  44. Remneva OV, Fadeeva NI, Fil’chakova ON, Burkova TV, Korenovskii YuV. Intranatal fetal hypoxia: diagnostic possibilities, reserves for reducing the frequency of cerebral disorders in full-term newborns. Rossiiskii vestnik perinatologii i pediatrii. 2015;5:61-66. (In Russ.).
  45. Compensatory mechanisms of fetal development in conditions of placental insufficiency. Ed. by VI Krasnopol’skii. Moscow: Medkniga. 2008;298. (In Russ.).
  46. Radzinskii VE. Obstetric aggression. Mediabyuro Status Presens. 2017;550-558. (In Russ.).
  47. Shekhtman MM. Guide to extragenital pathology in pregnant women. Moscow: Triada. 2008;815. (In Russ.).
  48. Extragenital pathology and pregnancy. Ed. by LS Logutova. Moscow: Litterra. 2013;582. (In Russ.).
  49. Vlasov PN, Petrukhin VA, Akhvlediani KN, Lubnin AYu. Neurological pathology and pregnancy. Moscow: MEDpress-inform. 2023;213. (In Russ.).
  50. Krasnopol’skii VI, Buyanova SN, Shchukina NA. Purulent-septic complications in obstetrics and gynecology: pathogenesis, diagnosis and therapeutic tactics. Russian Bulletin of Obstetrician-Gynecologist. 2007;7:5:76-81. (In Russ.).
  51. Serov VN, Sukhikh GT, Baranov II. Emergency conditions in obstetrics: A guide for physicians (library of a specialist doctor). Moscow: GEOTAR-Media. 2011;679-762. (In Russ.).
  52. Krasnopol’skii VI, Buyanova SN, Shchukina NA, Logutova LS. Failure of the suture (scar) on the uterus after cesarean section: problems and solutions (editorial). Russian Bulletin of Obstetrician-Gynecologist. 2015;15:3:4-8. (In Russ.). https://doi.org/10.17116/rosakush20151534-8
  53. Manukhin IB, Gogsadze LG, Ponomareva YuN. Differentiated therapeutic tactics in patients with endometritis after cesarean section. Khirurg. 2014;2:35-40. (In Russ.).
  54. Shchukina NA, Buyanova SN, Chechneva MA, Budykina TS, Blagina EI. Organ-sparing surgery in a patient with necrotic endometritis and an incompetent suture on the uterus after cesarean section. Russian Bulletin of Obstetrician-Gynecologist. 2016;16:4:80-84. (In Russ.). https://doi.org/10.17116/rosakush201616480-84
  55. An untenable scar on the uterus. Ed. by EYu Glukhov, SN Buyanova, LS Logutova, NA Shchukina, GB Dikke. Moscow: GEOTAR-Media. 2020;287. (In Russ.).
  56. Buyanova SN, Shchukina NA, Mgeliashvili MV, Titchenko YuP, Puchkova NV, Barto RA. Current diagnostic techniques for inconsistent uterine sutures or scar after cesarean section. Russian Bulletin of Obstetrician-Gynecologist. 2013;13:1:73-77. (In Russ.).
  57. Chechneva MA, Titchenko LI, Buyanova SN, Puchkova NV. Ultrasound diagnosis of an incompetent uterine scar in the remote postoperative period. SonoAce Ultrasound. 2011;22:35-39. (In Russ.).
  58. Buyanova SN, Shchukina NA, Logutova LS, Puchkova NV, Chechneva MA, Barto RA, Blagina EI. Diagnosis and management tactics in patients with an incompetent uterine scar after cesarean section at the stage of pregnancy planning. Russian Bulletin of Obstetrician-Gynecologist. 2015;15:5:82-88. (In Russ.). https://doi.org/10.17116/rosakush201515482-88
  59. Krasnopol’skii VI, Logutova LS, Buyanova SN. An untenable scar on the uterus after cesarean section: causes of formation and therapeutic tactics. Akusherstvo i ginekologiya. 2013;12:28-33. (In Russ.).
  60. Krasnopol`skii VI, Logutova LS, Buyanova SN, Chechneva MA, Akhvlediani KN. Results of operative obstetrical activity in modern obstetrics. Zhurnal akusherstva i zhenskikh bolesnei. 2015;64: 2:53-58. (In Russ.).
  61. Buyanova SN, Shchukina NA, Chechneva MA, Puchkova NV, Zemskova NYu, Torobaeva MT. Pregnansy in the scar after cesarean section: the possibility of surgical correction. Russian Bulletin of Obstetrician-Gynecologist. 2020;20:6:65-70. (In Russ.). https://doi.org/10.17116/rosakush20202006165
  62. Darwish HS, Habash YH, Habash MY. Ectopic pregnancies in caesarean section scars: 5 years experience. Clin Imag. 2020;66:26-34.  https://doi.org/10.1016/j.clinimag.2020.04.037
  63. Gabidullina RI, Shamsutdinova LG. On the use of prostaglandin E2 in pregnant women with a scar on the uterus after cesarean section. Russian Bulletin of Obstetrician-Gynecologist. 2013;2:48-52. (In Russ.).
  64. Ailamazyan EK, Kuz’minykh TU, Polenov NI, Shelaeva EV, Kolobov AV. Preparation of pregnant women with a scar on the uterus for delivery. Zhurnal akusherstva i zhenskikh bolesnei. 2008;LVII:1:3-9. (In Russ.).
  65. Bujold E, Blacwell SC, Gauthier RJ. Cervical ripening with transcervical foley catheter and the risk of uterine rupture. Obstet Gynecol. 2004;103:18-23. 
  66. Hawkins JL. The anesthesiologist`s role during attempted VBAC. Clin Obstet Gynecol. 2012;55:4:1005-1013.
  67. Barger MK, Bearmen S. A survey of access to trial of labor in California hospital in 2012. BMC Pregnancy Childbirth. 2013;13:83. 
  68. Postoperative scar on the uterus, requiring the provision of medical care to the mother during pregnance, childbirth and the postpartum period. Clinical recommendations. LLC «Russian Society of Obstetricians and Gynecologisrs» (ROAG) 2021; 40. (In Russ.).
  69. Vuchenovich YuD, Novikova VA, Radzinskii VE. Alternative to repeated cesarean section. Doctor.ru 2020;19:6:15-22. (In Russ.). https://doi.org/10.31550/1727-2378-2020-19-6-15-22
  70. Zharkin NA, Barinov SV, Logutova LS, Bindyuk AV, Miroshnikov AE, Shevtsova EP, Semikova TG. Pregnance and childbearing in women with an operated uterus: monograph. Volgograd: Publishing house VolgSMU. 2020;152. (In Russ.).
  71. Dy J, DeMeester S, Lipworth H, Barrett J. Trial of labour after caesarean. J Obstet Gynaecol Can. 2019;41:7:992-1011. https://doi.org/10.1016/j.jogc.2018.11.008
  72. Queensland Clinical Guidelines. Vaginal birth after caesarean (VBAC). Guideline No. MN20.12.V5—R25. Queensland Health. 2020. https://www.health.qid.gov.au/data/assets/pdf_file/0022/140836/g-vbac.pdf.
  73. ACOG Practice Bulleten No.205: Vaginal birth after cesarean delivery. Obstet Gynecol. 2019;133:2:110-127.  https://doi.org/10.1097/AOG.0000000000003078
  74. The Royal Australian and New Zealand College of Obstetricians and Gynecoljgists. Birth after previous caesarean section (C-Obs38); RANZCOG. 2019;25. 
  75. Vuchenovich YuD, Novikova VA, Radzinskii VE. Successful vaginal delivery after two caesarean sections. What are the chances? Russian Bulletin of Obstetrician-Gynecologist. 2020;20:5:61-67. (In Russ.). https://doi.org/10.17116/rosakush20202005161

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