C-Section

Question 1

What are the different types of c-section?

Answer 1

• Classical (vertical incision)
• Lower segment CS (horizontal incision)
• Caesarean hysterectomy

Question 2

Planned C-section reduces the risk of…

Answer 2

Obstetric shock, PPH, vaginal injury, perineal/abdo pain during birth

Question 3

What are the indications for planned c-section?

Answer 3

• Breech
• Multiple pregnancy
• Preterm birth
• Small for gestational age
• Placenta praevia
• Morbidly adherent placenta
• Risk of vertical transmission of infections (high viral load HIV, active HSV)
• Maternal request (but not with no reason)

Question 4

How are c-sections classified?

Answer 4

1 - Immediate threat to life of the woman or foetus
2 - maternal or foetal compromise which is not immediately life-threatening
3 - no maternal or foetal compromise but needs early delivery
4 - delivery timed to suit woman or staff

Question 5

How should the babies be cared for after c-section?

Answer 5

• Paediatrician presence
• Thermal care for baby
• Encouragement of maternal contact
• Breastfeeding (need additional support)

Question 6

How should the mother be cared for after c-section?

Answer 6

• High dependency unit admission (if needed)
• Routine monitoring
• Pain management
• Early eating/drinking
• Urinary catheter removal
• Respiratory physio (if needed)

Question 7

What is VBAC and what are the risks?

Answer 7

Vaginal birth after c-section

• Increased risk of uterine rupture
• Must not be induced

Question 8

What are the maternal complications of C-sections?

Answer 8

• Haemorrhage
• Wound/uterine infection
• VTE
• Bladder/bowel damage

Question 9

What are the foetal complications of C-sections?

Answer 9

• Respiratory morbidity
• Fetal laceration
• Worse bonding and breastfeeding (if emergency)

Question 10

What is the risk to further pregnancies of having a c-section?

Answer 10

Placenta praevia