C SECTION
Students:
• Modiga Daria
• Moneanu Anda
• Nica Maria-Cristina
DEFINITION
Cesarean is a surgical intervention designed to extract
the fetus from the pregnant uterus through a horizontal
incision of the abdomen above the pubic, practiced in
cases where the birth can not occur naturally.
The operation is practiced under anesthesia, which may
be general or peridural, in which case the pregnant
woman remains conscious during surgery.
CASES IN WHICH CESAREAN IS
RECOMMENDED
the uterus is malformed, fragile
caesarean
the basin is too narrow for the fetus to
pass
pregnant woman suffered from
hypertension during pregnancy
the child will be born prematurely (it is
premature) and the birth by normal
way could cause him a trauma due to
his weakness
the fetus is with the front seat,
pregnant woman is infected with HIV
ABSOLUTE INDICATIONS
Absolute disproportion:
Small maternal pelvis, making vaginal birth impossible
Chorioamnionitis (amniotic infection syndrome):
Infection of the placenta and possibly of the fetus, requiring immediate delivery
Maternal pelvic deformity:
Anatomical malformation, making vaginal birth impossible
Eclampsia and HELLP syndrome:
Life-threatening complications of pregnancy, usually leading to cesarean delivery
Fetal asphyxia or fetal acidosis:
Life-threatening situations for the fetus that can lead to fetal hypoxia
Umbilical cord prolapse:
Prolapse of the umbilical cord between the head of the fetus and the vaginal opening, which can lead
to fetal asphyxia
Placenta previa:
Anomalous placental position, impeding vaginal delivery
Abnormal lie and presentation:
Anomaly of fetal position that makes vaginal delivery impossible
Uterine rupture:
Acute situation threatening the life of both mother and fetus, requiring immediate delivery by
cesarean section
RELATIVE INDICATION
Pathological cardiotocography (CTG):
May provide indication of acute hypoxia or fetal asphyxia. If
fetal acidosis occurs, the birth should be completed either as an
instrumental delivery (suction and/or forceps) or by cesarean
section
Failure to progress in labor (prolonged labor, secondary
arrest):
Delayed delivery or cessation of labor can result in an adverse
outcome for the fetus or newborn
Previous cesarean section:
It is widely assumed that having had one cesarean section
makes it impossible to have a vaginal delivery in subsequent
pregnancies
PROCEDURE(DESCRIPTION)
In a C-section, the birth doctor, or obstetrician, makes a cut across the abdomen
and womb while the mother is under an epidural or spinal anesthetic. General
anesthesia is not common during a C-section.
The cut is normally between 10 and 20 centimeters (cm) in length.
With the epidural or spinal anesthesia, the lower body will remain pain-free
despite the mother not being fully unconscious. They may experience a tugging or
pulling sensation.
The obstetrician sometimes sets up a drape to block the view of the operation for
the mother, as this could cause distress despite not being painful.
Some hospitals allow the use of a transparent drape. The obstetrician and
midwives will keep the mother informed about progress as they operate.
Women who have undergone a C-section with previous babies may be candidates
for vaginal birth after C-section (VBAC). However, medical professionals do not
recommend this option for all women. Discuss the risks with a healthcare provider.
A C-section may be planned or unplanned for a multitude of reasons.
RISKS
A C-section comes with risks.
Potential problems the mother can experience include:
wound infection
blood loss
blood clots
injury to an organ, such as the bowel or bladder
adverse reactions to medication or anesthesia
potential complications during future pregnancies
Some women may also experience endometritis, an infection of
the lining of the uterus.
Risks to the infant include surgical injury and breathing
difficulties, such as transient tachypnea or respiratory distress
syndrome.
RISKS
Maternal risk profile
Increased maternal age pregnancy in a woman aged over 35
years has been considered a high-risk pregnancy
Obesity and diabetes mellitus
Fertility treatment Another much-discussed reason for the
observed increase in cesarean deliveries is the rise in assisted
reproductive interventions which increasingly are leading to
multifetal pregnancies.
Previous pregnancies a previous cesarean section does not
necessarily mean a required cesarean delivery in subsequent
pregnancies, the sense of security of physicians and mothers
seems to be responsible for repeated cesarean deliveries.
vaginal birth after previous cesarean delivery, there is a risk of
rare but serious adverse outcomes (increased rate of perinatal
deaths and hypoxic brain damage), whereas with repeat
cesarean the risks are more frequent but less serious.
Urinary and fecal incontinence and sexual dysfunction after
cesarean section
Tocophobia and anxiety states “tocophobia” is mainly used to
describe strong fear of spontaneous childbirth. This is the most
frequent reason for the request for an elective cesarean. In
addition to fear of giving birth vaginally, there is also an
association with numerous other factors such as fear of
complications for the child, previous traumatic births,
depression, abuse, and other psychosomatic/psychiatric reasons
RECOVERY
Following a C-section, a woman and her infant
can expect to remain in the hospital for 2–4 days.
The new mother is likely to experience pain at
the site of the incision, cramping, and bleeding
with or without clots for 4–6 weeks. The severity
of these symptoms will vary for different women
who have undergone the operation but should
improve fairly quickly as time passes.
Healthcare providers will recommend restricting
physical activity on returning home. Until a
doctor says that resuming normal activity is safe,
typically 4–6 weeks after surgery, they routinely
recommend that patients avoid strenuous
exercise, lifting heavy objects, placing anything
in the vagina, or having sex.
During the recovery period, a woman can take
the following steps:
maintain hydration by drinking plenty of water
take any medications as directed
SYMPTOMS AFTER C-SECTION
These symptoms could include:
fever
worsening pain
increased vaginal bleeding
increased redness at the incision
site
drainage or swelling of the
surgical incision
breast pain with redness or
fever
foul-smelling vaginal discharge
pain when urinating
PROGNOSIS OF THE CESAREAN SECTION SCAR
Report is made of a series of 144 patients in
whom hysterography was performed after a
cesarean section. Forty-five of these were
examined at the time of a later delivery, so that
the original x-ray characteristics could be
correlated with subsequent actual observation. Of
25 with a normal hysterogram, 24 were found to
have a clinically normal scar. Of 12 in whom
early x-ray had revealed only a characteristic
isthmic defect, "the common postsurgical defect,"
all were found to have a clinically normal scar.
Of 5 where x-ray studies had shown
abnormalities of the uterine cavity, at
examination after delivery 3 appeared to have
normal scars, but 2 suffered uterine ruptures. It is
concluded that the common postsurgical isthmic
defect is of little significance and may be
transitory. The finding, however, of x-ray
evidence of an abnormality of the uterine cavity
is of serious import
