Caesarean section is a surgical technique to remove the fetus by making an abdominal incision from the uterus. This is done by your gynecologist surgeon. A caesarean may be planned. Sometimes it must be done urgently for a medical reason-which contraindicates a vaginal delivery or where an emergency fetal extraction.is required
Indications for a planned caesarean section
-Previous cesarean section: A single uterine scar is not an indication for caesarean section. But if the maternal pelvis is too small (as measured by X-ray pelvimetry), the indication arises.However a multi scarred uterusis an indication for caesarean section.-Non-cephalic fetal presentation:-Breech presentation. We should still note that breech presentation is not an absolute indication for a cesarean delivery. Several parameters must be taken into account and only your surgeon can tell you exactly the way forward.-Brow presentation or transverse presentation.-Fetal macrosomia: A fetal macrosomia in diabetic women is an indication.-Relative fetal macrosomia : The term "relative" means that the baby's weight is too large relative to the size of the maternal pelvis (ray pelvimetry).-Twins: When the first twin presents itself in the breech position most surgeons perform a Caesarean section.-Placenta previa.-Certain fetal malformations..-Cervical cancer.-Maternal disease prohibiting expulsive efforts.
Indications for emergency caesarean
-Fetal distress during labor.-Prolapsed umbilical cord.-Uterine rupture.-Retro placental hematoma-Maternal dystocia.-Fetal dystocia.-Failed induction of labor.-Genital herpes outbreak within 8 days prior to delivery.-Maternal hemorrhage.
Emergency Caesarean section :
You're giving birth, and suddenly,you have to have a caesarean. How is it done?You are taken to an operating room and you are placed on the operating table. If it has not been done already, you will have your pubis shaved . Depending on the maternity wards, they will just shave the upper pubic part or a full.shave You get undressed and you wear a paper hat You might be offered a pill or a drink that helps prevent vomiting during surgery. At this stage it is still possible to request a sedative to be more relaxed during the operation. If you already have an epidural, the anesthesiologist adds an extra dose of epidural Otherwise we will give you an, anesthesia: more often we give you a spinal anesthesia but if it is contraindicated then a general anesthesia.Meanwhile,if he is expected , the father in a paper hat gown and slippers can join you in the operating room.You are cleaned with Betadine,from the navel to the top of the thighs. The surgical assistant will then put up the "fields", a sheet stretched over your chest and then raised to the vertical height of the stomach to prevent you from seeing the surgeon's actions..If the surgeon uses a scalpel, you will have a metal plate on the thighs.Your husband (if his presence is allowed), can stand next to your head and the operation begins.Your baby is born ... The planned caesarean section is conducted under the same terms, in the operating room, except that, obviously you are taken directly to the room to have the Caesarean section. You are then monitored for 2 hours in the recovery room or delivery room. Then you are taken to your room where the first lactation is possible.
The surgical technique
We will briefly describe here the most common technique.Once anesthetized, the surgeon begins the operation:-Horizontal transverse abdominal incision above pubis-The surgeon performs successively the opening of the abdominal muscles and the layer of peritoneum (tissue lining the abdominal cavity) to reach the uterus. The opening takes place with fingers or scissors.-A transverse incision is made in the uterus: it is a hysterotomy: the uterus is opened.-The surgeon introduces his hand into the uterus to extract the fetus.-The baby comes out. Its umbilical cord is cut. The child is given to the midwife.-The surgeon repairs the uterus manually (they check that the entire placenta has been expelled).-They then close the various openings made.-The operation is finished.
After the operation
After a cesarean section the length of hospitalization is slightly longer than a natural vaginal delivery. However, you can breastfeed and care for your baby as after a normal deliveryA cesarean section does not prevent you from having other pregnancies later. Apart from some cases, a natural vaginal delivery can often be seen in subsequent pregnancies.
Benefits
-Reduces the maternal or fetal risk where caesarean section was indicated.-Eliminates the risk of perineal trauma (perineal tear, anal incontinence).
Disadvantages and risks
A caesarean section is a common procedure in which the process is simple in most cases.During the operation, damage to adjacent organs of the uterus may occur in exceptional cases: bowel injury, urinary tract or blood vessels, requiring a specific surgical treatment. In the exceptional case of bleeding from the uterus that can threaten the life of the patient, a blood transfusion or blood products may be necessary. In this situation, if the specific medical and surgical treatments used to treat the haemorrhage is ineffective, it may be necessary to achieve very exceptionally a hysterectomy (removal of the uterus to stop bleeding). It is a hemostase hysterectomy.In the aftermath of the operation the first 24 hours are often painful and require strong analgesics. Sometimes a hematoma or infection (abscess) of the scar may occur, requiring the most simple local care. It is not uncommon for a urinary tract infection occurring, usually harmless after a caesarean. Except in special cases, anticoagulant therapy is prescribed during the hospitalization to reduce the risk of venous thrombosis (a clot in a vein in the legs) or pulmonary embolism. Exceptionally, a severe infection or bleeding may occur in the days following the operation and require specific treatment or further surgery. Like any surgery, cesarean section may have very rarely life-threatening or serious sequelae
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Victor Hugo