[Fetal lesions due to the bistoury during cesarean section: a study of 58 cases. The 5-year case records of 3117 cesarean sections at the Institutes of Clinical Obstetrics and Gynecology of the University of Rome La Sapienza].

In the present article the authors have carried out a statistical investigation on data relative to the caesarean sections performed in the Departments of Obstetrics and Gynaecology of the University of Rome "La Sapienza" since 1986 to 1990. Particular object of this study is to evaluate data regarding fetal bistoury lesions incidentally caused while performing the incision of the uterine wall during a caesarean section. To our knowledge, this topic has never been taken into account by the world's literature, nevertheless it is important also for its legal and insurance implications. Throughout the mentioned period 13787 deliveries occurred, 3117 of which were caesarean sections: this is equal to a frequency of 22.6%, with an increase rate of 37.5% during the whole 5 years time. 58 cases of fetal bistoury lesions have been found to occur since 1986 to 1990: this equal to 1.8% of all the performed caesarean sections. Even if their gravity was usually scarce, and only 7 cases needed a specific treatment, 25.8% of these lesions involved areas such as forehead, cheek bone, cheek, mostly related to possible aesthetic damages with their connected legal consequences. In order to evaluate what factors can contribute to the occurrence of these lesions and taking account of the large number of factors that may be involved (such as conditions at which the operation is performed, skill and experience of the surgeon etc.), the authors focus their attention to those which, for their clinical significance and possibility of detection, suit more than others such a statistical investigation.(ABSTRACT TRUNCATED AT 250 WORDS)