Extraperitoneal cesarean section in the profoundly infected patient

Abstract

• 1. 38 per cent of all cesarean section deaths are due to infection and usually follow transperitoneal operations done upon cases which have violated certain important criteria.

• 2. There is disagreement over the best method for delivery of the infected patient who cannot be delivered vaginally of an intact infant. The difference of opinion lies between cesarean hysterectomy, embryotomy, extraperitoneal cesarean section and transperitoneal cesarean section with local administration of sulfonamides.

• 3. Infected cases treated by extraperitoneal cesarean section are reported without maternal mortality.

• 4. Transperitoneal cesarean section in infected cases is pointed out as dangerous even though advantage is taken of the modern antibiotics and chemotherapeutic agents.

• 5. Difficult embryotomy is pictured as being outmoded and reprehensible.

• 6. Cesarean hysterectomy is criticized as being a mutilating and dangerous procedure when used in primigravidas, even though severe intrauterine infection is present.

• 7. The modern technique of extraperitoneal cesarean section is the safest and simplest method of treating severely infected cases when vaginal delivery of an intact infant cannot be consummated.