Casarean section Flashcards
What are the types of cesarean sections?
Classical or upper cesarean section.
Low cesarean section.
What is the rate of cesarean sections (in percent) in Norway?
15-16 %.
What are common maternal indications to perform a c-section?
Previous cesarean section Failure to progress Antepartum haemorrhage Prevention of vertical transmission Contracted pelvis/CPD
What are common fetal indications to perform a c-section?
Fetal Distress.
Malpresentation/malposition.
Fetal abnormality.
Multiple pregnancy – Monochorionic twin.
What are possible intraoperative complications when performing a c-section?
Difficult abdominal entry Difficult delivery of the baby Hemorrhage Injury: to urinary tract, bowel, fetus, etc. Anesthetic complications.
What are possible early postoperative complications following a c-section?
Reactionary hemorrhage Urinary retention Paralytic ileus DIC Thromboembolism Pelvic Infection Wound complications such as hematomas or infection.
What are possible late postoperative complications following a c-section?
Rupture of uterus. Need for repeat c-section. Intra-abdominal and intrauterine adhesions Incisional hernia Fistulae Psychological Medicolegal issues
How are the maternal risks of morbidity and mortality for delivery through c-section compared to vaginal birth?
There is increased risk of maternal mortality and
severe acute morbidity, and a higher risk for adverse outcomes in subsequent pregnancy compared with vaginal birth.
Multiple c-sections are associated with a higher risk of maternal morbidity and mortality.
What are benefits or c-section delivery?
Maternal benefits: Less frequent incontinence and urogenital prolapse.
Fetal benefits: Safer for the fetus. Less risk of hypoxic-ischemic encephalopathy (HIE).
What are ways of preventing the “popularity” of having a c-section?
The delivery fees for physicians for undertaking c-sections and attending vaginal delivery should be the same.
Hospitals should be obliged to publish annual c-section rates, and financing of hospitals should be partly based on c-section rates.
Hospitals should use a uniform classification system for c-sections (Robson/WHO classification).
Women should be informed properly on the benefits and risks of a c-section.
Money that will become available from lowering c-section costs should be invested in resources, training and reintroduction of vaginal instrumental deliveries to
reduce the need for c-section in the second stage of labor.
In rural areas, adequate access to skilled care, to appropriate fetal surveillance, and to assisted births or operative delivery is essential.
