Cesarean section is the most commonly performed procedure in obstetrics and is an important means of resolving difficult deliveries. As one of the countries with high cesarean section rate in the world, China's cesarean section rate has decreased in recent years under a series of measures. However, the adjustment of fertility policy has increased the number of people who are re-pregnant after cesarean section, and the incidence of placenta implantation has increased, which also brings about an increase in postpartum hemorrhage and other related complications. With the changes in the spectrum of obstetric diseases, the decision-making on the mode of delivery is more complicated. Therefore, the standardized application of cesarean section is particularly important.

Preoperative preparation
For cesarean section performed after rupture of fetal membranes, vaginal preparation is recommended and povidone-iodine or chlorhexidine may be applied to reduce the risk of endometritis.

Surgical approach
① Try not to manually detach the placenta during surgery to reduce the risk of endometritis.

② Uterine suture should be single or bilateral suture is acceptable and does not increase the risk of uterine rupture and postpartum hemorrhage in the event of a second pregnancy.

③ Suturing the peritoneum is not recommended and can shorten the operation time and reduce the patient's pain.

Postoperative analgesia
① Discuss the issue of postoperative analgesia with the mother. The choice of pain medication depends on the severity of pain, whether or not she is breastfeeding, and the type of anesthesia.

② For women under intrathecal anesthesia, intrathecal injection of 0.3~0.4mg diacetylmorphine can be given to reduce the need for postoperative narcotic analgesic drugs. If intrathecal injection is not feasible, an epidural injection of 2.5 to 5 mg can be given.

(iii) Acetaminophen or a nonsteroidal anti-inflammatory drug (e.g., ibuprofen), used in combination, can be used for postoperative analgesia to reduce dependence on opioids and gradually transition to discontinuation.