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Rupture of a caesarean scar during a trial of vaginal birth: a dramatic consequence as old as the modern caesarean section
Author(s) -
Jauniaux Eric
Publication year - 2016
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14173
Subject(s) - caesarean section , medicine , uterine rupture , obstetrics , pregnancy , vaginal delivery , vaginal birth , surgery , uterus , genetics , biology
ERIC JAUNIAUX, PROFESSOR IN OBSTETRICS AND FETAL MEDICINE, INSTITUTE FOR WOMEN’S HEALTH, UNIVERSITY COLLEGE LONDON, LONDON, UK Among other pioneering surgical procedures, John Hunter (1728– 1793), the father of modern surgery, is credited to have performed the first caesarean section deliveries using an evidence-based anatomical approach (Moore W, The Knife Man, Bantam Press, 2005). Even if his procedures were technically successful – and Hunter managed to deliver a few live and surviving babies – the mother inevitably died, mainly because of the lack of suitable suturing material and wound infection. Thus, until the 19th century, caesarean section remained a surgical procedure of last resort performed almost exclusively to save the baby’s life. It is only when surgeons started to suture the uterus after delivery that the maternal death rate started to fall. Further technical advances in surgical techniques during the early 20th century reduced the complication rates of caesarean section substantially. As a result, mothers not only survived the surgical procedure but were also able to have one or more subsequent pregnancies.