17) Cesarean Section

Question 1

What is the definition of Cesarean Section?

Answer 1

• Delivery of newborn via surgical incision thru abdominal wall + uterus
• Done via laparotomy / hysterotomy

NB! EITHER Elective (Planned) or Emergent

Question 2

What are the Advantages / Disadvantages?

Answer 2

ADVANTAGES

• Safest Method IF maternal / fetal health is compromised by vaginal delivery

DISADVANTAGES

• Post-Op Complications
• Long Recovery Period

Question 3

What are the Types of C-Section?

Answer 3

1) TRANSVERSE Incision (MOST COMMON)

• Made in lower uterine segment
• Decreases RISK of adhesions / hemorrhages
• BUT a risk to injure major vessels, or cervix / vagina inferiorly

2) CLASSIC Incision

• Made in upper uterine segment
• Good thing is fetus can be in any lie
• Has a SHORTER incision-to-delivery Period
• Done when there’s been… Placenta Previa, Previous C-Section

NB! Around 1000ml BLOOD LOSS

Question 4

What are the Indications for a C-Section?

Answer 4

MATERNAL

• Placental Previa (ABSOLUTE Indication)
• Preeclampsia
• Uterine Myoma
• Placental Abruption, Cord Prolapse, Uterine Rupture, Vaginal Bleeding - EMERGENCY!
• Upon request (RELATIVE Indication)

FETAL

• Multiple Pregnancies (RELATIVE Indication)
• Growth Retardation
• Malformations (Hydrocephalus)

Question 5

What is the Surgical Procedure of C-Section?

Answer 5

1) Prepare Patient
2) Anesthesia
3) Abdominal Incision
4) Uterine Incision
5) Delivery of Infant –> Placenta

6) Wound Closure
7) Close Abdominal Incision

Question 6

What are the Complications for a C-Section?

Answer 6

MATERNAL

• Infection = Endomyometritis, UTI, Wound
• Hemorrhage
• Surgical Injury to bowel, bladder, ureter
• Uterine Rupture

FETAL

• tachypnoea of newborn
• Acute Respiratory Distress Syndrome (ARDS)