In all of the folllowing indications of Cesarean sections a Lower segment caesarean section is preferred over classical, except:
**Core Concept**
Lower segment caesarean section (LSCS) is preferred over classical caesarean section due to its lower risk of complications, such as uterine rupture in future pregnancies, and easier access for future surgeries. LSCS involves a transverse incision in the lower segment of the uterus, whereas classical caesarean section involves a vertical incision in the upper segment.
**Why the Correct Answer is Right**
The correct answer is B. **Previous classical caesarean section**. In a woman with a previous classical caesarean section, a lower segment caesarean section is not preferred because it increases the risk of uterine rupture in future pregnancies. This is due to the fact that the classical incision is located in the upper segment of the uterus, which is under more tension and stress during subsequent pregnancies, increasing the risk of rupture.
**Why Each Wrong Option is Incorrect**
* **Option A:** **Breech presentation** does not contraindicate a lower segment caesarean section. In fact, a lower segment caesarean section is often preferred for breech presentation due to the ease of access and lower risk of complications.
* **Option C:** **Multiple gestations** does not contraindicate a lower segment caesarean section. In fact, a lower segment caesarean section is often preferred for multiple gestations due to the ease of access and lower risk of complications.
**Clinical Pearl / High-Yield Fact**
A mnemonic to remember the indications for classical caesarean section is "BREACH": **B**reech presentation, **R**efractory labor, **E**mergency situations, **A**bnormal fetal position, **C**hronic conditions, and **H**istory of previous classical caesarean section.
**Correct Answer:** B. Previous classical caesarean section.