C sections

Question 1

what is a C section

Answer 1

delivery of the fetus through an incision in the abdo wall and uterus

Question 2

types of C section

Answer 2

lower uterine segment incision - 99%, horizontal incision

classical - longitudinal incision in upper segment of uterus, rarely done

Question 3

indications for classical C section

Answer 3

very premature fetus

very rapid delivery required

Question 4

indications for C section

Answer 4

fetal distress
failure to progress in labour 
failed induction
malpresentation
severe pre-eclampsia
placenta praevia
twin pregnancy w/ non-cephalic presenting twin
repeat C section

Question 5

categories of C section

Answer 5

I - emergency
II - urgent
III - scheduled
IV - elective

Question 6

emergency C section
timing
situation

Answer 6

within 30 mins
immediate threat to woman or fetus
e.g. eclampsia, severe placental abruption

Question 7

urgent C section
timing
situation

Answer 7

within ~90 mins

maternal/fetal compromise but not immediately life threatening

Question 8

scheduled C section
timing
situation

Answer 8

no time limit

requiring early delivery but no compromise

Question 9

elective C section
timing
situation

Answer 9

no time limit

at a time to suit woman and maternity team

Question 10

complications of C section

Answer 10

injury to surrounding structures
haemorrhage
DVT
infection

Question 11

preventing complications of C section

Answer 11

prophylactic abx

low molecular weight heparin

Question 12

long term risks of C section impacting future pregnancies

Answer 12

placenta praevia or accreta
antepartum stillbirth
uterine rupture
post-op adhesions - subfertility