Cesarean Section | Lecture Note

University:
The University Of Western Ontario
Course:
ANAT 2200B | Systemic Anatomy of the Human Body
Academic year:

2022
Views:

81

Pages:

3
Author:

Kyuwon J.

C-sec ● Cesarean section ○ Surgical delivery on baby through incision on abdominal wall + uterus ■ Fetal distress ■ Failure to progress labour ● Obstructed labour ■ Malpresentations ● Breech ● Transverse ■ Placenta previa ● Placental complications ■ Multiple pregnancy ● twins/triplets ■ Hx of C-sec ● VBAC eligibility dependent ■ Maternal conditions ● Severe pre-eclampsia ● Infection ● Side effects ○ Risk on mother (short term) ■ Surgical anesthesia risk ● Pain in incision site ● Bleeding ● Postpartum hemorrhage ● Infections ○ Wound infection ○ Uterine infection ■ Endometritis ● Blood clots ○ DVT ○ Pulmonary embolism risk after surgery ● Injury to organs ○ Usually to nearby organs ○ Bladder injury ○ Bowel injury ■ rare , still possible ● Adverse effect from anesthesia ○ Nausea ○ Vomiting ○ Low blood pressures ■ spinal /epidural ● Recovery related effects ○ Longer hospital stay compared to vaginal delivery ○ Slower return to normal activity ○ Fatigue ○ Limited mobility ○ Delayed breastfeeding ○ Risk on mother (long term) ■ Scar and pelvic comp ● Scar pain ● Sensitivity ● Adhesions ○ Internal scar tissue ○ Contribute to chronic pelvic pain ○ Future abdominal surgery ● Uncommon, but incisional hernia also is a risk for mothers ■ Future pregnancy risks : important points!! ● Placenta previa ○ Placenta covered in cervix ● Placenta accreta spectrum ○ Attached deeply into the wall of uterine ● Uterine rupture ○ Not a risk right now but if so when there will be future labour ○ Additional risk if attempting VBAC ● Increased chance of C-sec in future ○ Risk for baby ■ Short term ● Breathing difficulties ○ TTB ○ Respiratory distress (not common) ● Accidental skin cut (rare) ● Altered early feeding ○ Since baby need monitoring ■ Long term ● Not guaranteed but must be reported ○ Increased risk in asthma/allergies ○ Early microbiomes and colonization are different from normally born babies ○ Not directly caused C-sec benefits (when to use) ● C-sec are used to prevent major damage in case where vaginal delivery is considered “not safe” ○ If prolonged fetal oxygen deprivation while distress ○ Maternal fetal trauma reduction during labour ○ Severe bleeding scenarios ○ Placenta previa ○ Can be a safe option for some malpresentations