Caesarean Section Flashcards
Risk of emergency hysterectomy caesarean?
7-8 per 1000
VTE risk caesarean
4-16 per 10,000 women
bladder injury risk caesarean
1/1000
ureteric injury risk at Caesarean
1/10,000
death risk CS
1/12,000
Risk of uterine rupture in future after one CS
2-7/1000
Risk of stillbirth after previous CS
1-4/1000
risk of placenta praevia and accreta with previous cs
4-8/1000
Frequent maternal risks of LSCS
Pain 9/100 repeat CS 1/4 readmission 5/100 haemorrhage 5/1000 infection 6/100 fetal laceration 1-2/100
Extra procedures which may become necessary during LSCS?
hysterectomy, blood transfusion, repair of damage to bowel, bladder or vessels.
Three main fetal injuries at CS?
- skull fracture or ICH following disimpaction
- BPI following difficult shoulder delivery
- Cervical spine, spinal cord and/or vertebral artery injury following delivery of after coming head in breech
Additional risks when CS with fetal head deeply in pelvic?
fetal injury (skull #, ICH) maternal injury: tears, haemorrhage, UTI
Safety checks before fully dilated CS
- senior VE immediately prior
- steady, firm, upward pressure with cupped hand or insertion fetal pillow
- experienced Obstetric/paeds attending or available if difficulty in delivery predicted
- anaesthetics prepared for need to tocolyse or manage PPH
If shoulder dystocia is encountered with delivery at CS, what can be done?
extend incisions to facilitate manoeuvres such as posterior arm delivery
convert uterine incision to T or J
What can cause cervical spine/cord or vertebral artery injury in breech delivery?
hyperextension of the cervical spine with breech delivery.
