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GYN/OBS > Cesarian Section > Flashcards

Cesarian Section Flashcards

OBS

1
Q

Most significant operative intervention in obstetrics

A

Cesarian section

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2
Q

CS

Indications for CS

A
  • Repeat CS
  • Abnormal labour- dystocia
  • Breech
  • Fetal distress
  • Placenta previa
  • Umbilical cord prolapse
  • Uterine rupture
  • Malpresentation- brow
  • Maternal conditions- severe pre- eclampsia
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3
Q

CS

Classifications of urgency to do a CS

A

Categories 1 to 4

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4
Q

CS

Category 1 of urgency to do a CS

A

Threat to life of mother or baby. Delivery is indicated** within 30 minutes. **

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5
Q

CS

Instances of category 1 urgency

A
  • Uterine rupture
  • severe prolonged bradycardia
  • Cord prolapse
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6
Q

CS

Category 2 of urgency to do a CS

A

Maternal or fetal compromise not immediately life threatening. but as soon as possible consider other potential risks

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7
Q

CS

Category 3 of urgency to do a CS

A

No maternal or fetal compromise but early delivery is indicated.

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8
Q

CS

Category 4 of urgency to do a CS

A

Elective CA. timed suit to woman and patients

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9
Q

CS

Instances of category 2 urgency

A
  • Ante- partum hemorrhage
  • Non- progressive labor
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10
Q

CS

Instances of category 3 urgency

A
  • Delivery is good within 75 minutes
  • worsening IUGR and pre- eclampsia
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11
Q

CS

Steps in CS

A
  1. Incise the skin
  2. Incise the rectus
  3. Incise the peritoneum
  4. Seperate the visceral peritoneum
  5. Expose the uterus and incise the uterus
  6. Rupture the membranes
  7. Deliver the baby
  8. Deliver the placenta
  9. Identify the uterine incision
  10. Suture the uterine incision
  11. Close the rectus sheath
  12. Suture the skin- subcuticular
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12
Q

CS

Types of CS incisions of the uterus

A
  • Lower segment uterine incision
  • Classical uterine incision
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13
Q

CS

Lower segment uterine incision

A

Incised area is less vascular than other parts. Uterine closure is easier. Quick healing Reduced risk of rupture in the subsequent PG

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14
Q

CS

Classic uterine incision

A
  • Chance of uterine rupture is high
  • Rarely done unless absolute indications are present
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15
Q

CS

Absolute indications to do a classical uterine incision

A
  • If the lower uterine segment has adhesions, fibroids
  • CA in the cervix
  • The baby is in transverse lie with the back down
  • Placenta previa
  • Conjoined twins
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16
Q

CS

Most commonly used uterine incision

A

Lower uterine segment transverse incision

17
Q

CS

Anesthesia used

A
  • Spinal
  • Epidural
  • General
18
Q

CS

MC used anesthesia

A

spinal - Single shot, immediate relief, lasts 1-2 hours

19
Q

CS

When is General anesthesia used

A

In situations where speed is required. in instances where regional anesthesia is contraindicated. In emergency situations

20
Q

CS

Pre- op assessment

A
  1. Informed written consent
  2. Tests- FBC, Cross match 1 unit blood
  3. Antacid prophylaxis
  4. Anesthetist assessment
  5. catheterize
21
Q

CS

Catheter is inserted in the….. position

A

15 degree left lateral position to reduce the risk of aorto- caval compression

22
Q

CS

Three types of abdominal incisions

A
  • Transverse curvilinear incision
  • Transverse suprapubic incision
  • Vertical skin incision
23
Q

CS

Transverse curvilinear incision

A

2 finger breadths above the symphysis pubis

24
Q

CS

Transverse suprapubic incision

A
  • No curve
  • Improved cosmetic results
  • Reduced analgesics needed
  • Better wound strength
25
Q

CS

Vertical skin incision

A
  • In obese mothers
  • Suspicion of other intra- abdominal pathology
26
Q

CS

What’s given to aid in uterine contractions and to expel the placenta

A

Syntocinon (IV)

27
Q

CS

When is syntocinon given

A

once the fetus is delivered

28
Q

CS

12 steps done post- op

A

4 THINGS TO MONITOR
* Monitor- vitals
* Monitor UOP
* Monitor QHT
* Monitor bleeding- PV bleeding
4 THINGS TO GIVE
* IV fluids - NS, Hartmanns until the pt starts feeding
* ABx- may continue sometimes
* DVT prophylaxis - enoxaparin
* Analgesics
4 THINGS TO DO
* Start feeding within 2H after uncomplicated delivery
* Remove the catheter when the pt is mobile without support
* Mobilization
* Wound care

29
Q

CS

How often should you monitor vitals post- op

A

BP, RR , PR
* 1/4hourly for 2H
* 1/2hourly for 2H
* Hourly for 2H

30
Q

CS

How often should you monitor UOP post- op

A

hourly

31
Q

CS

DVT prophylaxis?

A

Most mothers are obese
PG is a hypercoagulable state

32
Q
A

GYN/OBS (6 decks)

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