Relevance. Cesarean section, also known as C-section, or caesarean delivery, is the use of surgery to deliver babies. A cesarean section is often necessary when a vaginal delivery would put the baby or mother at risk. This may include obstructed labor, twin pregnancy, hig blood pressure in the mother, breech birth, or problems with the placenta or umbilican cord. A cesarean delivery may be performed based upon the shape of the mother’s pelvis or history of a previous C-section. A trial of vaginal birth after cesarean section may be possible. The World Health Organization recommends that Caesarean section be performed only when medically necessary. Some C-sections are performed without medical reason, upon request by someone, usually the mother [1, 2].

A C-section may be done with a spinal block, where the woman is awake or under general analgesia. A urinary catheter is used to drain the bladder and the skin of the abdomen is then cleaned with an antiseptic. An incision of about 15 cm (6 inches) is then typically made through the mother’s lower abdomen. The uterus is then opened with a second incision and the baby delivered. The incisions are then stitched closed. A woman can typically begin breastfeeding as soon as she is awake and out of the operating room. Often, several days are required in the hospital to recover sufficiently to return home [2].

C-sections result in a small overall increase in poor outcomes in low-risk pregnancies. They also typically take longer to heal from, about six weeks, than vaginal birth. The increased risks include breathing problems in the baby and amniotic fluid embolism and postpartum bleeding in the mother. Established guidelines recommend that cesarean sections not be used before 39 weeks of pregnancy without a medical reason. The method of delivery does not appear to have an effect on subsequent sexual function [2, 3].

Objective: to study and analyze the frequency of causes cesarean section in India and Russia in the period from 2005 to 2015 years.

Research objectives:

1. Еvaluate the structure of the causes of cesarean section in India.

2. Еvaluate the structure of the causes of cesarean section in Russia

3. Conduct a comparative analysis of the frequency of causes of cesarean section in India and Russia in the period from 2005 to 2015 years.

Table 1. Absolute causes of cesarean section in India.

Table 2. Main indications for cesarean section based on obstetric and gynecological history.

Table 3. Extragenital pathology of the mother.

Caesarean section in Russia.

Absolute indications from mother and fetus:

Obligatory indications found in the parturient woman: anatomically narrowed pelvis; early placental abruption in normal location; complete placenta previa; bleeding with incomplete presentation; severe preeclampsia and eclampsia, renal insufficiency; scar tissue of the pelvis, vagina, the walls of the uterus, cervix, tumor neoplasms of the pelvic organs, fistulas of the genital organs and intestines.

From the side of the fetus: transverse, oblique, pelvic presentation; incorrect entry of the head into the birth canal; prolapse of the umbilical cord; acute oxygen starvation; death or maternity death [6].

Relative indications from the mother and fetus.

From the side of the pregnant: a clinically narrowed pelvis; lasting from the 20th week of pregnancy and poorly treatable; extragenital diseases, which with natural delivery will lead to a significant deterioration in health; weak labor activity, pathological process of the generic process; congenital pathologies of genital organs; postterm pregnancy; age over 30, especially in women giving birth for the first time.

From the side of the fetus: a chronic impairment of blood circulation between the fetus and the placenta; early discharge of water in the pelvic presentation or the age of the first-born for 30 years; weight more than 4 kg.

Indications for caesarean section in terms of vision refer to the relative indications from the mother: the dystrophy of the fundus; eye trauma; experienced surgery due to detachment of the retina; myopia; strong myopia in minus seven diopters and more [6].

Indications for emergency surgery:

Cesarean section is usually planned in advance. But sometimes there are situations in which emergency intervention is the only way to save the life of the mother and baby. This is an operation for life indications: too large for the pelvis head, the detection of pathology in the process of childbirth; early discharge of amniotic fluid in the absence of labor; weak birth of the uterus even after the stimulation of childbirth; placental abruption during labor; threat of rupture of the uterus or the beginning of a rupture – with such trauma there is a severe bleeding; prolapse of umbilical cord loops and blockage by their head; hypoxia of the fetus, threatening its death; preeclampsia of a pregnant woman, and renal failure [6].

Table 4. Comparative analysis of the frequency of causes of cesarean section in India and Russia in the period from 2005 to 2015.

* – statistically significant differences

Conclusions:

1. The most significant causes of cesarean section in India are medical abortion (35.7%), the carrier of human papillomavirus and cytomegalovirus (28.8%), chlamydia (22.7%), ureaplasmosis (15.6%), myoma of the uterus (14.5%).

2. The most significant causes of cesarean section in Russia are medical abortion (28.6%), the carrier of human papillomavirus and cytomegalovirus (32.3%), chlamydia (18.7%), hypertension (11.7%).

3. A comparative analysis of the frequency of causes of cesarean operation in India and Russia showed that a significantly larger percentage of causes is aggravated obstetric and gynecological history.

1. Biswas, A; Su, LL; Mattar, C. Caesarean section for preterm birth and, breech presentation and twin pregnancies /  Best Practice & Research. Clinical Obstetrics & Gynaecology. – 2013. – Vol. 27 (2). – P. 209–19.
2. DC Dutta textbook of obstetrics & gynecology 8th edition.
3. Althabe, F., Sosa, C., Belizan, J.M., Gibbons, L., Jacquerioz, F. and Bergel, E., 2016. Cesarean section rates and maternal and neonatal mortality in low, medium, and highincome countries: an ecological study. Birth, 33(4), pp.270-277.
4. Indian national health programes.
5. Indian medical health association.
6. Strizhakov A. N., Lebedev V. A. Cesarean section in modern obstetrics. — М.: Medicine, 2018. — 304 p.  — ISBN 5-225-02757-1.

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