Caesarian Section

Question 1

Classification of Emergency Caesarian Section Category 1

Answer 1

Category 1: immediate threat to the life of mother or fetus

Fetal distress
Ruptured uterus
Fetal bradycardia
Bleeding placenta previa with maternal shock
Failed vacuum with fetal tachycardia
Cord prolapse

Question 2

Classification of Emergency Caesarian Section Category 2

Answer 2

There is maternal or fetal compromise but no immediate threat to life of woman or fetus

Malpresentation in Labour
Cord presentation in latent phase 1st stage
APH with no fetal distress or maternal shock

Question 3

Classification of Emergency Caesarian Section Category 3

Answer 3

There is need for early delivery but no maternal or fetal compromise.

Latent 1st stage in woman booked for elective C/S
Fetal Macrosomia in latent 1st stage
Footling breech in early labour

Question 4

Classification of Emergency Caesarian Section Category 4

Answer 4

Delivery at a time to suit the woman and the maternity team.

2 previous C/S
Multiple pregnancy with first fetus in non cephalon position
HIV, massive Volvo-vaginal warts, HSV

Question 5

Fetal Indications for C/S

Answer 5

Fetal distress
CPD / Feto-pelvic disproportion
Obstructed Labour
Malpresentations
Malposition
Cord prolapse
High order multiple pregnancy
IUGR
Severe Oligohydramnios
Congenital anomalies
Placenta abruptio/Placenta previa

Question 6

Maternal Indications for C/S

Answer 6

Previous uterine surgery (extensive myomectomy, corneal resection, metroplasty)
Repaired ruptured uterus
Classical C/S scar
2 previous lower uterine segment c-section
One previous lower uterine segment C-section with breech, face, malposition, twins.
Previous VVF repair or pelvic floor repair
Pelvic fractures, pelvic deformity
Maternal infections such as HIV, active genital herpes simplex infection, massive vulvovaginal warts
Patients choice