Giving birth to an infant is a risky job if the mother has some serious complications. In those situations, doctors perform Cesarean Section. It is an operative procedure which reduces the complications of delivery to a great extent.
It is an operative procedure whereby the fetuses after the end of 28th week are delivered through an incision on the abdominal and uterine wall.
Absolute: Vaginal delivery is not possible. Cesarean section is needed even with a dead fetus.
- Grossly contracted pelvis.
- Central placenta praevia.
- 2 or more cesarean section.
- Pregnancy following successful repair of V.V.F.
- Transverse lie at term.
Relative: vaginal delivery may be possible but risk to the mother and/or baby are high.
- Previous cesarean delivery.
- Non reassuring F.H.R.(fetal distress.)
- Failed induction.
- Hypertensive disorder.
- Medical disorder.
Time of operation:
Type of operation:
Classical or upper segment.
- Informed written consent for the procedure, anesthesia and B.T.
- Abdomen is scrubbed with soap, hair may be clipped.
- Antacid, H2 blocker to raise the gastric pH.
- Bladder should be empty-by a soft rubber catheter.
- Stomach should be empty (N.P.O.-6 hours before operation).
- F.H.S. should be checked.
- Neonatologist should be available.
S.A.B. (sub arachnoid block), epidural or GA may be given.
Position of the patient:
Dorsal. 15◦ tilt to left.
Incision on the abdomen:
Post operative care:
- Monitoring of vital sign-pulse, BP, respiration, temperature, dehydration, behavior of the uterus, P/V bleeding, urinary output.
- I/V fluid.
- Prophylactic antibiotics.
- Baby is put to the breast.
- Anesthetic hazards- Mendelson’s syndrome, cardiac arrest, Hypotension.
- Extension of uterine incision.
- Injury to the UB,ureter and rectum.
- P.P.H. – atony, morbid placental adhesion.
- Aspiration pneumonia.
- Intestinal obstruction.
- Wound complication-haematoma, dehiscence, burst abdomen.
- Secondary P.P.H.
Incisional hernia, intestinal obstruction.Scar rupture.
Iatrogenic prematurity, R.D.S.
Thus, Cesarean Section is a widely used procedure on the eve of one’s birth!