Table 3 Examples of scenarios under each indication that the panel members agreed on the appropriateness (inappropriateness) of cesarean section.*

Repeat cesarean with

Three or more previous cesarean (A)

Classic scar (A)

Unknown scar (A)

Previous rupture of uterine (A)

Preterm delivery with

Down syndrome (I)

Anencephaly (I)

Eclampsy <30 weeks of pregnancy (A)

History of fever in previous cesarean due to infections (A)

Fetal distress

Sever Decolman (A)

Bradycardia (A)

Tachycardia (A)

Decrease of variability (A)

Chronic distress

IUGR^, BPS^# normal, pregnancy <30 weeks and Bishop score <5 (A)

IUGR, BPS normal, pregnancy <30 weeks and Bishop score >5 (A)

ADF^$, IUGR, BPS normal, pregnancy 34-37 weeks (A)

ADF, IUGR, BPS normal, pregnancy 30-34 weeks (A)

Macrosomia and

Diabetic mother, fetal weight > 4000 g (A)

Parity > 5 (A)

Previous traumatic delivery (A)

Post term > 41 weeks, Bishop appropriate (I)

Multiple pregnancy

Twin, mono amnion with sonography (A)

Twin, di-amnion, both non cephalic, normal weight and age (A)

Twin, cephalic-non cephalic, both with normal weight (A)

Twin, non cephalic-cephalic, both with normal weight (A)

Breech and

Decolman (A)

Placenta previa (A)

Nuliparous mother (A)

Unknown footling (A)

Dystocia of soft tissues

Arrest of dilatation: delayed long phase (more than 3 hours in nullipara and more than 1 hour in multipara) with appropriate contraction, no CPD (A)

Arrest of dilatation (more than 2 hours in nullipara & multipara) with appropriate contraction, no CPD (I)

Failure to progress: nulliparous, insufficient dilatation of cervix ( < 1.2 cm/hr), appropriate contraction, no CPD (I)

Failure to progress: multiparous, insufficient dilatation of cervix ( < 1.5 cm/hr), appropriate contraction, no CPD (A)

Pelvic dysfunctions and abnormal presentation of fetus

Inlet: posterior-anterior diameter <10 cm (A)

Inlet: transversal diameter <12 cm (A)

Inlet and mid pelvic contraction (A)

Fetal anomaly

Hydrocephalus fetus (A)

Macrocephalus fetus (A)

NTD Open (A)

Hydrops fetalis (A)

Mother characteristics

> 12 kg weight increase in pregnancy (I)

> 18 kg weight increase in pregnancy (I)

Sever coronary artery disease (A)

Mother with asthma (A)

Uterine anomaly

Previous surgery on uterine including opening the endometrial tissue (A)

Pelvic contraction caused by rickets or trauma (A)

Over distention of the uterine and need to end the pregnancy (A)

Hemorrhage and premature rupture of membrane

Rupture of membrane for <18 hours (I)

Rupture of membrane for >18 hours and lack of labor (I)

Rupture of membrane >5 hours in patients with HIV (A)

Previa, fetus ≤34 week, light vaginal hemorrhage (I)