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Y4R2 - Obstetrics I 🤰 > L2: Cesarean Section > Flashcards

L2: Cesarean Section Flashcards

1
Q

Def of CS

A
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2
Q

Incidence of CS

A
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3
Q

Types of CS

A
  • According to operative method
  • According to time of performing
  • According to number of CS
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4
Q

Types of CS

  • According to operative method
A
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5
Q

Types of CS

  • According to time of pregnancy
A
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6
Q

Types of CS

  • According to number of CS
A

1) 1ry CS: 1st CS.
2) Repeated CS: 2nd, 3rd, 4th, 5th, …

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7
Q

Indications of CS

A
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8
Q

Indications of CS

  • Faults in power
A

Uterine underactivity or overactivity.

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9
Q

Indications of CS

  • Faults in passages
A
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10
Q

Indications of CS

  • Faults in passengers
A

1) Undeliverable presentations (see obstructed labor).

2) Large sized fetus (macrosomia).

3) Congenital anomalies (as hydrocephalus & conjoined twins).

4) Locked twins.

5) Placental site Hge (placenta previa or placental abruption).

6) Prolapsed pulsating cord with incompletely dilated cervix.

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11
Q

Indications of CS

  • Diseases of mother
A

1) Severe hypertensive disorders.

2) DM (with polyhydramnios, preeclampsia, macrosomia, IUGR or bad obstetric history).

3) Severe heart disease (cases with restricted COP).

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12
Q

Indications of CS

  • Fetal Condition
A

1) Fetal distress.

2) Postmaturity.

3) Rh isoimmunization.

4) Vasa previa.

5) Precious baby (elderly primigravida, history of infertility or bad obstetric history).

6) Habitual IUFD during last few weeks of pregnancy (CS is done 1 week earlier than date of death of previous fetus).

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13
Q

CI of CS

A
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14
Q

General Steps of CS

A
  • US
  • Perparation of Patient
  • Actual Technique
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15
Q

General Steps of CS

  • US
A

To

  • Confirm fetal viability & maturity
  • Exclude malformations & multifetal pregnancy
  • Localize placental site.
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16
Q

General Steps of CS

  • Preparation of patient
A
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17
Q

General Steps of CS

  • Tecnique of USCS
A
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18
Q

Tecnique of USCS

  • Abdominal Incision
A

Paramedian incision.

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19
Q

Tecnique of USCS

  • centralize the uterus
A
  • to correct dextrorotation & dextroposition.
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20
Q

Tecnique of USCS

  • uterine incision
A
  • Anterior central midline subumbilical incision vertical incision (in least vascular area) is done in peritoneum, muscle layer & decidua till amniotic sac or placenta appears

(if placenta is anterior, either cut through it or sweep it off uterus to reach amniotic cavity).

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21
Q

Tecnique of USCS

  • Rupture the amniotic membrane
A

…

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22
Q

Tecnique of USCS

  • Deliver fetus
A

Grasp foot of fetus & deliver it as breech.

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23
Q

Tecnique of USCS

  • Clamp & divide umbilical cord
A

…

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24
Q

Tecnique of USCS

  • Deliver placenta & membranes
A

…

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25
Q

Technique of USCS

  • Explore uterine cavity
A

for remnants or congenital anomalies.

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26
Q

Technique of USCS

  • Ensure that cervix is dilated
A

to allow passage of lochia.

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27
Q

Technique of USCS

  • Suture the uterine incision
A

(in 2 layers)

a) Interrupted sutures in deep muscle layer beneath decidua.

b) Interrupted layer taking peritoneum & muscle layer.

28
Q

Technique of USCS

  • Abdominal toilet
29
Q

Technique of USCS

  • Close abdominal wall in layers
30
Q

Technique of Transverse LSCS (Munro kerr)

31
Q

Technique of Transverse LSCS (Munro kerr)

  • abdominal incision
A
  • Pfannenstiel incision or midline subumbilical incision.
32
Q

Technique of Transverse LSCS (Munro kerr)

  • centralize the uterus
A
  • & put Doyen’s retractor in lower abdominal incision to retract bladder & protect it.
33
Q

Technique of Transverse LSCS (Munro kerr)

  • Uterine Incision
  • Rupture the amniotic membrane
A

a) Transverse incision in peritoneum of LUS below white line & dissect upper & lower flaps together with bladder from underlying LUS.

b) Transverse incision in LUS (Munro Kerr’s incision) & incision is enlarged by either 2 index fingers or by scalpel or scissor

…..

34
Q

Technique of Transverse LSCS (Munro kerr)

  • Deliver fetus
35
Q

Technique of Transverse LSCS (Munro kerr)

  • Clamp & Divide umbilical cord
36
Q

Technique of Transverse LSCS (Munro kerr)

  • Deliver placenta & Membrane
37
Q

Technique of Transverse LSCS (Munro kerr)

  • explore uterine cavity
A

for remnants or congenital anomalies.

38
Q

Technique of Transverse LSCS (Munro kerr)

  • Ensure that cervix is dilated
A

to allow passage of lochia

39
Q

Technique of Transverse LSCS (Munro kerr)

  • Suture the uterine incision
A

(in 3 layers)

  • Continuous sutures in muscle wall but not including decidua.
  • Interrupted inverted Lambert’s sutures in muscle to cover 1st layer.
  • Closure of peritoneum.
40
Q

Technique of Transverse LSCS (Munro kerr)

  • abdominal toilet
41
Q

Technique of Transverse LSCS (Munro kerr)

  • Close abdominal wall in layers
42
Q

Indications of USCS

43
Q

Advantages of USCS

44
Q

Disadvantages of USCS

45
Q

Advantages of Transverse LSCS

46
Q

Disadvantages of Transverse LSCS

47
Q

Def of Cesarean hystrectomy

A

CS & removal of uterus at the same operation.

48
Q

Indications of Cesarean hystrectomy

49
Q

postmortem / Perimortem CS

  • Time Allowed for delivery
A
  • Postmortem CS is done within 10 minutes of maternal death (after taking consent) to save life of living fetus (by rapid extraction of fetus by USCS under maternal cardiac massage & lung oxygenation).
50
Q

postmortem / Perimortem CS

  • Indications
A

Perimortem CS is done in cases of brain death & post-arrest syndrome.

51
Q

Complications of CS

52
Q

Complications of CS

  • Immediate
53
Q

Complications of CS

  • Remote
54
Q

Prognosis of CS

55
Q

Indications of CS with Sterialization

56
Q

How to Reduce Rate of CS?

57
Q

How to Reduce Rate of CS?

  • Limit Indications
58
Q

How to Reduce Rate of CS?

  • Labor
59
Q

How to Reduce Rate of CS?

  • Fetal Distress
60
Q

How to Reduce Rate of CS?

  • Educational Program for pregnant Lady
61
Q

Introduction to VBAC

62
Q

Prerequisities of VBAC

63
Q

CI of VBAC

64
Q

Complications of VBAC

65
Q

Prognosis of VBAC

66
Q

Success Rate of VBAC

67
Q

Factors Predicting Successful VBAC

Y4R2 - Obstetrics I 🤰 (59 decks)

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