Friday, November 14, 2003

Cesarean Sections

I got an e-mail from the Italian office yesterday: My publisher just had her second son by "cesarean cut," to use the phrase from the e-mail. Naturally, this phrasing raised some questions in the U.S. office. Although the procedure is called a "cesarean section" in English, the Italian term is taglio cesareo, literally "cut cesarean." French and Spanish simplify things to césarienne and cesárea respectively, while German uses Kaiserschnitt, "imperial cut."

At first the "imperial" bit seems a bit out of place, then I found this (from "Cesarian Section: A Brief History" at the National Library of Medicine): "Even the origin of "cesarean" has apparently been distorted over time. It is commonly believed to be derived from the surgical birth of Julius Caesar ..." The Caesar link is clearer in British English, where the preferred spelling is caesarean, than in U.S. English.

The brochure disparages the link to Caesar, noting that at the time of little Julius's birth
... such a procedure was performed only when the mother was dead or dying, as an attempt to save the child for a state wishing to increase its population. Roman law under Caesar decreed that all women who were so fated by childbirth must be cut open; hence, cesarean.
Also offered as a possible origin is the Latin word caedare, to cut. The brochure notes that the term caesones "was applied to infants born by a postmortem operation." The term "cesarean section" came into widespread usage following the 1598 publication of Jacques Guillimeau's book on midwifery; previously, it had been called a cesarean operation.

A sidenote: The National Library of Medicine has a small online exhibiton of Medieval manuscripts in its collection. The images aren't the clearest, but there are some neat pieces in the exhibition.

Of course, any thoughts of cesareans or any other method of birthing are still a long ways off for us. After getting a call yesterday afternoon, the doctor has scaled back our stimulation doses to a half ampoule each of Gonal-f and Repronex. Evelin notes that this is a ridiculously small amount of medicine and that she has never heard of anyone going through IVF needed so little medicine. Part of the concern is that her estrogen (E2) levels were rising very quickly. They would like to see a smoother curve in hopes of staving off ovarian hyper stimulation syndrome (OHSS). The high E2 levels also help explain the nausea Evelin's been feeling. (She'd attributed it to my driving, but it looks like there is a medical reason instead.) This morning, the follicle count was 16 on the right and 10 on the left, and some of them were larger than 10 mm, which is a good, but happening rather quickly. My guess is that they are going to have us coast (i.e., skip a Gonal-f/Repronex injection) a night or two as we get closer to the retrieval ... which is only a week away.

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