Cesarean Section Flashcards
Rate of adhesions at umbilicus after midline incision?
55%
Rate of adhesions at umbilicus after low transverse incision?
23%
Do we need to do bladder dissection in case of classical cs
No
A subsequent trial of labour is allowed for women with previous classical caesarean section?
No it’s contraindicated due to risk of uterine rupture
rate of bladder injuries that need repair
1-100
Rate of CS deliveries
25%
15% emergency
10% elective
Most common causes of unplanned CS
Labor dystochia
Fetal hypoxia
Malpresentation
When HIV is an indication of CS
VL<50: vaginal - VBAC
VL 50-399: consider CS
VL>400: CS
Timing of CS in HIV pts
If bec. Prevention of vertical transmission: 38-39w
If bec. Of obs indications: >39w
If women requested CS d.t. Tokophobia
Refer to psychomental health
ECV should be offered for breech except
- in labour
- uterine scar or abnormalities
- fetal compromise
- ROM
- vaginal bleeding
- medical conditions
When to offer ECV in breech
36 w
If unsuccessful, declined orCI, offer CS
When to perform CS in multiple pregnancy
If the first not cephalic
CS indications in SGA
- Abnormal DV
- poor STV in cCTG
- AREDV
Do CS reduces risk of vertical transmission in women with hepatitis C
No
Offer CS IF: hepatitis C+ HIV
When to offer CS for HSV
In primary genital HSV in the 3rd trimester
Management of 1ry genital HSV IN 3rd trimester
Consider acyclovir 400 mg TDS until delivery
- planned CS
Do a BMI>50 alone an indication for CS
No
Timing of planned CS
Not before 39 w to reduce neonatal respiratory distress
Surgical site infection prevention
- Alcohol based chlorhexidine
- Alcohol based iodine
- AB before insicion (not coamoxiclav)
Best CS Incision
Joel cohen (3cm above SP)
Methods to assist cs in fully dilated women
- push method
- pull method (reverse breech extraction)
- patwardhan’s method
- fetal pillow
- C-snorkel
When do we routinely close subcutaneous tissue
If more than 2 cm
Indications of myomectomy with CS
- Fibroids causing difficulty with closure of the uterine incision
- to facilitate safe delivery of the fetus
- large fibroids greater than 6 cm in diameter
- visible subserosal fibroids
