The C-section is a technique whose origins have been lost over time. For centuries it was a post-mortem surgery used to extract the fetus from the abdomen of a deceased woman. In the late Middle Ages, it gradually became an emergency technique used to save the child. However, the incised uterus was replaced in the abdomen without sutures, and this step led to the death of mothers for more than four centuries.
Thanks to the Italian Surgeon, Dr. Eduardo Porro (1842-1902), this technique became safe enough to save both the mother and the child for the first time. On May 21, 1876 at the Hospital of St. Matthew of Pavia, Dr. Porro successfully operated on Mrs. Giulia Cavallini whose pelvis, which had been damaged by rickets, had a birth canal that prevented the natural passage of the fetus. Dr. Porro performed a C-section on her accompanied by a peripartum hysterectomy., Finally, Dr. Porro brought the uterine stump outside in the suprapubic area of the abdomen, where the wound could be easily treated with the recently introduced antiseptic solution. This technique, despite its invasiveness, thwarted deadly complications, such as heavy bleeding and puerperal fever for the first time. Dr. Porro’s accomplishments marked a decisive turning point in medical history. Still today, the emergency peripartum hysterectomy (EPH) is used in cases of unresponsive heavy bleeding or in developing countries where it is not easy to transfuse the patient.,
It was a few years later that we arrived at the modern (and conservative) C-section. This was a result of two major innovations. The first was introduced by Dr. Ferdinand Adolf Kehrer (1817-1914), who incised transversally the lower segment of the uterus (the part of the uterus with less bleeding). The second advancement was made by Dr. Max Saenger (1853-1903), who sutured the muscle layer of the uterus with silver thread. The silver sutures produced minimal tissue reaction and were associated with a low rate of uterine infection. These surgical innovations saved the lives of children and preserved the fertility of the mother. However, in trying and difficult circumstances we must not forget the emergency peripartum hysterectomy.
 Donald Todman, 2007, A history of caesarean section: From ancient world to the modern era, Australian and New Zealand Journal of Obstetrics and Gynaecology, Vol. 47, No. 5, pp. 357-361.
 E. Porro,1876, Della amputazione utero-ovarica come complemento di taglio cesareo. Rechiedei.
 C. Godson, 1884, Porro’s Operation, BMJ, Vol. 1, No. 1204, pp. 192-192.
 Machado LSM. Emergency peripartum hysterectomy: Incidence, indications, risk factors and outcome. NorthAmerican Journal of Medical Sciences. 2011; 3(8):358-361. doi:10.4297/najms.2011.358.
 Eltabbakh, G.H. et al., Postpartum hysterectomy. International Journal of Gynecology and Obstetrics, Vol.50 , Issue 3 , 257 – 262.