Caesarean Sections Flashcards
What is a caesarean section?
A caesarean section is a surgical procedure to deliver a baby through an incision in the abdominal wall and uterus.
What are the types of caesarean sections?
Types include elective caesarean section (planned before labour) and emergency caesarean section (performed during labour due to complications).
What are the indications for an elective caesarean section?
Indications include breech presentation, placenta praevia, multiple pregnancies, previous caesarean section, and maternal request.
What are the indications for an emergency caesarean section?
Indications include fetal distress, failure to progress in labour, uterine rupture, cord prolapse, and placental abruption.
How is a caesarean section classified by urgency?
Classification includes Category 1 (immediate threat to life), Category 2 (maternal or fetal compromise), Category 3 (no immediate risk), and Category 4 (elective).
What preoperative preparations are needed for a caesarean section?
Preparations include informed consent, fasting, IV access, prophylactic antibiotics, and thromboprophylaxis.
What is the most common type of uterine incision in caesarean sections?
The lower segment transverse incision is most common due to its lower risk of complications and better healing.
What is the “classical” caesarean section?
A classical caesarean involves a vertical uterine incision, typically reserved for cases like placenta praevia or uterine abnormalities.
What anaesthetic options are used for caesarean sections?
Options include regional anaesthesia (spinal or epidural) and general anaesthesia, with regional preferred in most cases.
What are the key steps in a caesarean section procedure?
Steps include abdominal incision, uterine incision, delivery of the baby, delivery of the placenta, and closure of the uterus and abdomen.
What are the intraoperative complications of caesarean section?
Complications include haemorrhage, bladder or bowel injury, uterine rupture, and anaesthetic complications.
What are the postoperative complications of caesarean section?
Complications include infection, thromboembolism, wound dehiscence, and adhesions.
What prophylactic measures are used to prevent infection during caesarean section?
Prophylactic antibiotics, typically a single dose of IV cefuroxime, are given preoperatively.
What is the role of thromboprophylaxis in caesarean sections?
Thromboprophylaxis includes low-molecular-weight heparin (LMWH) and compression stockings to reduce the risk of venous thromboembolism.
How long does recovery typically take after a caesarean section?
Recovery typically takes 4-6 weeks, but full recovery can vary depending on complications and individual factors.
What are the potential impacts of a caesarean section on future pregnancies?
Risks include uterine rupture, placenta accreta, placenta praevia, and increased likelihood of repeat caesarean sections.
What is a “trial of labour after caesarean” (TOLAC)?
TOLAC refers to attempting vaginal delivery in a woman with a previous caesarean section.
What factors influence the success of a vaginal birth after caesarean (VBAC)?
Factors include the type of previous uterine incision, absence of obstetric complications, and the reason for the previous caesarean.
What are the contraindications for VBAC?
Contraindications include a classical uterine incision, previous uterine rupture, or multiple previous caesarean sections.
How is pain managed postoperatively after a caesarean section?
Pain is managed with a combination of paracetamol, NSAIDs, and opioids if needed.
What advice should be given to women post-caesarean about wound care?
Women should keep the wound clean and dry, avoid heavy lifting, and watch for signs of infection like redness, swelling, or discharge.
What is a gentle caesarean, and how does it differ from a traditional caesarean?
A gentle caesarean focuses on creating a more natural birthing experience, involving techniques like delayed cord clamping and immediate skin-to-skin contact.
How can the risk of adhesions be minimised during a caesarean section?
Adhesion risk can be minimised by meticulous surgical technique and limiting unnecessary surgical procedures.
What psychological impacts can a caesarean section have on women?
Women may experience feelings of failure, anxiety, or postpartum depression, especially if the caesarean was unplanned or emergency.
What are the benefits of regional anaesthesia over general anaesthesia for caesarean section?
Benefits include reduced maternal risks, faster recovery, and the ability for the mother to be awake during delivery.
How should women be counselled about repeat caesarean sections?
Counselling should include discussing risks, benefits, and alternatives like VBAC, as well as future family planning considerations.
