We will conduct a brief review of the history, origins and evolution of caesarean section. Caesarean section is an extremely old surgical procedure. It seems that it was already known in the year 715 BC. as historians have investigated.
Then, a Roman law dictated by Numa Pompilio, the "lex caesarea", prescribed its use as a way to remove the baby from the mother's womb when she had just died, in order to bury them separately and, rarely, to save Baby's life
Legend has it that Julio César was born through an operation like this in the year 100 B.C., and from there would come the name, although it is likely that it actually derives from the previous law. In addition, the term could be derived from the Latin verb will fall, "cut, make a fissure".
Most likely it is a combination of the above. The beginning of the story is almost certainly the verb fallen: in Rome the explicit phrase "a matre caesus" ('cut from his mother') was used to describe the operation.
The etymological relationship of the name César by the history of the birth of the emperor by this procedure is already old, but we already know the taste for popular etymologies.
The title of the "lex caesarea" must be influenced by this legend, in a mixture of "caesus" and "Caesar". Another curiosity: in German it is said Kaiserschnitt (literally, "the cut of the emperor"), no doubt coming directly from the legend of the birth of Julius Caesar.
Survival throughout the history of caesarean section
The first of these operations in which it is known that both the mother and the baby survived It happened in Switzerland in 1500. It is believed that Jacob Nufer, a pig castrator, did this operation to his wife after a long work. It seems that the woman had five more births spontaneously.
Trautman (Germany) used it in 1610, in another case in which the mother survived. But these were rare cases: most of the time, the procedure had a high mortality. In the 17th and 18th centuries other cases were referred, but the operation fell into disrepute because of its high mortality
There is a history of the late 1700s and early 1800s of caesarean operations performed in cases of difficult births in order to try to save the lives of mother and child. The success rates were extremely low.
In 1751 there is written documentation indicating that the caesarean section should be performed in women whose vaginal delivery was impossible, indicating that this was an opportunity to save maternal and fetal lives.
Even when the son occasionally survived, the operation was almost always fatal to the mother. In the second half of the 19th century in Britain and Ireland the mortality was 85% (1865). Although the operation was having various refinements, until the 20th century the maternal death rate as a sequel to the operation was 75%.
Phillep Physicj proposed in 1822 the basis for extrapertoneal cesarean section. In 1882, Max Sänger wrote a treatise that made time, describing the use of uterine suture almost the same as it is done today, and proposed the operation known as "Classical Caesarean section."
When medical techniques gradually improved, the first caesarean operations were performed where the lives of the mother and the son were insured. The key measures in the mortality reduction were:
- Reception of the principles of asepsis.
- The introduction of uterine suturing by Max Sänger in 1882.
- Extraperitoneal caesarean section (surgical removal of the fetus through an incision in the lower segment of the uterus, without penetrating the peritoneal cavity) and then moving to the lower transverse incision (Krönig, 1912).
- Advances in anesthesia.
- Blood transfusion.
- Antibiotics
Frank, in 1906, described the caesarean section of the lower segment, penetrating the uterus extraperitoneally. In 1908, Latzko developed another access method and later other authors introduce variations and improvements in the technique, as well as new techniques.
Caesarean section in Africa
Regarding other continents, European travelers in the region of the great lakes of Africa observed during the nineteenth century that caesarean sections were performed in different communities on a regular basis. There are testimonials from then of caesarean sections practiced in Uganda and Rwanda.
The mother was normally anesthetized with alcohol, the wound was cauterized to reduce bleeding. The abdomen was massaged to promote contraction and the wound was attached with iron needles. In addition, a mixture of herbs was used to improve recovery.
Given the well-developed nature of the procedures employed, and the recovery of the mothers, the observers concluded that they had been employed for some time, it is not known for sure since when.
The image that heads this article corresponds to the practice of a caesarean section in Uganda, and dates from 1879.
We finish this brief historical review of caesarean section with data that seems incredible. On March 5, 2000, a Mexican, Inés Ramírez, had a cesarean section herself and survived, as did her son. It is believed that she has been the only woman who has had a C-section herself and has survived.
