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Table 1 Classification of the indications for caesarean section *

From: Effects of caesarean section on maternal health in low risk nulliparous women: a prospective matched cohort study in Shanghai, China

Absolute indications Relative indications
• Serious pelvic stenosis or abnormal pelvis
• Severe antepartum bleeding, such as placental praevia and placental abruption
• Abnormality of soft birth canal, such as scar tissue or pelvic tumour impeding presentation descent and diaphragm of vagina
• Scar of uterus
• Abnormal foetal presentations, such as mixed breech presentations
• Pre-rupture of uterus
• Foetal malformation, such as conjoined twins
• After repair operation of reproductive organ fistula
• Relative cephalopelvic disproportion, such as poor engagement of foetal head and foetal macrosomia
• Foetal distress
• Pregnancy complications, such as cardiac disease, renal disease and liver disease in pregnancy
• Other indications, such as uterine inertia
  1. * The categories of indications were set down according to the Practice Guidelines for Gynaecology and Obstetrics in Shanghai [21] and the opinions of the expert team on this project. Accordingly, foetal distress refers to the presence of meconium in the amniotic fluid concomitant with increased or decreased foetal heart rate. Lactic acidosis assessment is not generally available.