So-called "classic" (corporal), cesarean section, with where the body of the uterus is cut longitudinally in modern obstetrics applies only in rare and exceptional cases, for example,if uterine fibroids and the need for hysterectomy, with operations in the dead womanat intensity of bleeding. In a longitudinal dissection of the body of the uterus occurs significant injury of muscle fibers, blood vessels, nerves,hindering formation of a full rumen. The only advantage of this technique Caesarean section is the speed of opening of the uterus and remove the fetus (Fig. 126).

By rarely performed procedure also applies ekstraperitoneal-tion Caesarean section, in which paravezikalno or retrovezikalno reveal lower segment of the uterus without opening the peritoneum. This method of abdominal delivery contraindicated in suspected rupture of the uterus, with premature detachment normally situated placenta, placenta previa, varicose veins of the lower segment of the uterus, the presence of uterine fibroids, the need to perform sterilization. The major indication for its implementation are infected childbirth.However, hopes for an absolute freedom from infectious complications by extraperitoneal access to the uterus is not justified, as significant role in the spread of infection are hematogenous and lymphogenous way.

In addition, the operation of extraperitoneal cesarean technically complex, the risk of serious complications (bleeding from predpuzyr-Term fiber injury of the bladder, urethra), and in many cases accompanied by a violation of the integrity of the peritoneum. In connection with all The above features of extraperitoneal cesarean section, this technique has limited application.

Before proceeding to describe the surgical technique of caesarean section, should stay on the specifics of the anatomy and topography of the uterus in late pregnancy. Uterus at term fills the small pelvis, abdominal cavity and its bottom rests on the lower surface of the liver. The shape of the uterus represents ovoids, rotated from left to right,ie, the left edge and the left round uterine ligament close to the anterior abdominal wall,and the right edge uterus - to posterolateral. The bottom of the uterus is covered with the front seal and the transverse colon, the front surface of the body of the uterus and the isthmus are free from loops of bowel and directly adjacent to the anterior abdominal wall.