14 - Obs - Instrumental and Operative Delivery - C/S

Question 1

Classic c-section is what? when is this indicated? (3 things)

Answer 1

vertical uterine incision

if fetus transverse, multiple fibroids, extreme prematurity

Question 2

Common reasons for emergency Cs - 2

Common reasons for elective Cs - 2

Answer 2

Failure to progress in labour
fetal distress

prev C/S
breech presx

Question 3

Absolute indications for elective C/s

• ??
• severe antenatal ? compromise
• ? abnormal lie
• prev ? c sec
• gross ? deformity

Answer 3

PP
fetal
uncorrectable
vertical/classical
pelvic

Question 4

Relative indications for elective cs

• ? presx
• severe ????
• ?
• ??/other medical problems
• prev cs
• ? ? women

Answer 4

breech
IUGR
twins
DM
older nulliparous

Question 5

CS - definition of type/urgency

• emergency - ? threat to mother or fetus eg severe ? ?
• urgent - maternal/fetal compromise not immediately ?-? eg ?
• scheduled - needing ? delivery but no compromise
• elective -at time to suit ? and team
• Peri-postmortem - For fetus and mother during maternal ?/for fetus after maternal ?

Answer 5

immediate
fetal distress
life-threatening
dystocia
early
mother
arrest
death

Question 6

Maternal complx
? and need for transfusion, infection of ?/?, rare visceral eg ? or ? damage, post-op pain and ?, and ???. Prophylactic ? reduce incidence of infection, ?measures routine. 1/5000 ?
rate.

Answer 6

haemorrhage
wound/uterus
bladder
bowel
immob
VTE
Abx
thromboprophylactic
death

Question 7

Fetal Complx
Elective: incr risk of fetal ?
morb at any ?, so if uncompx not before ?wks. Still occurs in 4%. Fetal ? rare/minor. ? and ? esp affected by emergency procedure.

Answer 7

resp
gestation
39
lacerations
bonding
BFeeding

Question 8

Complx - Subsequent pregs

• no ? to CS’s - but get more ?
• small incr in ? in next preg
• incr risk of ?? next preg - also ? and ? may occur

Answer 8

limit
difficult
stillbirth
PP
accreta
percreta