In otherwise uncomplicated twin pregnancies at term where the presentation of the first twin is cephalic, perinatal morbidity and mortality is increased for the second twin. However, the effect of planned Caesarian section in improving outcome for the second twin remains uncertain and therefore Caesarian section should not routinely be offered outside a research context. Do not do November 2011 Unclassified
The risk of neonatal morbidity and mortality is higher with 'small for gestational age' babies. However, the effect of planned Caesarian section (CS) in improving these outcomes remains uncertain and therefore CS should not routinely be offered outside a research context. Do not do November 2011 Unclassified
Pelvimetry is not useful in predicting 'failure to progress' in labour and should not be used in decision making about mode of birth. Do not do November 2011 Unclassified
Shoe size, maternal height and estimations of fetal size (ultrasound or clinical examination) do not accurately predict cephalopelvic disproportion and should not be used to predict 'failure to progress' during labour. Do not do November 2011 Unclassified
Do not offer a Caesarian section on the grounds of HIV status to prevent mother-to-child transmission of HIV to: women on highly active anti-retroviral therapy (HAART) with a viral load of less than 400 copies per ml or women on any anti-retroviral therapy with a viral load of less than 50 copies per ml. Inform women that in these circumstances the risk of HIV transmission is the same for a Caesarian section and a vaginal birth. Do not do November 2011 Unclassified
Mother-to-child transmission of hepatitis B can be reduced if the baby receives immunoglobulin and vaccination. In these situations pregnant women with hepatitis B should not be offered a planned Caesarian section because there is insufficient evidence that this reduces mother-to-child transmission of hepatitis B virus. Do not do November 2011 Unclassified
Women who are infected with hepatitis C should not be offered a planned Caesarian section because this does not reduce mother-to-child transmission of the virus. Do not do November 2011 Unclassified
Do not use a body mass index (BMI) of over 50 alone as an indication for planned Caesarian section. Do not do November 2011 Unclassified
The following aspects of intrapartum care have not been shown to influence the likelihood of Caesarian section for 'failure to progress' and should not be offered for this reason, although they may affect other outcomes which are outside the scope of this guideline: active management of labour early amniotomy. Do not do November 2011 Unclassified
The risk of respiratory morbidity is increased in babies born by Caesarian section (CS) before labour, but this risk decreases significantly after 39 weeks. Therefore planned CS should not routinely be carried out before 39 weeks. Do not do November 2011 Unclassified