الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cesarean section (CS) is defined as “fetal delivery through an open abdominal incision (laparotomy) and an incision in the uterus (hysterotomy)”. The first cesarean documented occurred in 1020 AD, and since then, the procedure has evolved tremendously.(1) CS is now the most common surgery performed worldwide.(2) CS can be classified according to urgency into four categories:(3)
• Category 1: Immediate threat to the life of the woman or fetus (for example, suspected uterine rupture, major placental abruption, cord prolapse, fetal hypoxia or persistent fetal bradycardia). It is recommended to perform the delivery as soon as possible, ideally within thirty minutes from presentation.
• Category 2: Maternal or fetal compromise which is not immediately life-threatening. Again, recommended to be performed as soon as possible, with an ideal time window of 75 minutes from presentation.
• Category 3: No maternal or fetal compromise but needs early birth.
• Category 4: Birth timed to suit woman or healthcare provider.
Examples of cases fitting each of the CS categories:(4)
• Category 1: Fetal bradycardia with fetal heart rate (FHR) < 100 beat per minute (bpm) for > 5 minutes duration with no return to the baseline.
• Category 2: Breech presentation in active labour unsuitable for vaginal birth.
• Category 3: Suspected Intrauterine growth restriction (IUGR) unsuitable for vaginal birth with normal Cardiotocogram (CTG).
• Category 4: Planned elective cesarean sections (ElCS).
Regarding the uterine closure technique, both the single and double layer techniques were comparable in various important aspects. The need for blood transfusion was more or less the same when using either of the techniques. Similar relationships were found when comparing the need for additional surgical procedures, the rate of uterine rupture, and the need for antibiotics shortly after delivery. The single layer technique was expectedly associated with shorter duration of surgery, as it saves 2 to 15 minutes from operating time. The latest NICE guidelines