Caesarean section by UM
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Caesarean section by UM

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  • 1. CAESAREAN SECTION
  • 2. Definition
    • delivery of a fetus by incision through the abdominal wall and uterus
  • 3. Types of Caesarean Section LSCS (Lower segment Caesarean section) Upper segment / Classical Caesarean section
    • Transverse incision over the lower segment of the uterus
    • Relatively avascular
    • Does not take an active part in contraction and retraction during labour
    • Access to the presenting part of the fetus
    • Encourages good healing
    • Vertical incision over the fundus and body of the uterus
    • More vascular
    • Takes an active part in contraction and retraction during labor
    • Does not give access to the presenting part
    • Poor healing
  • 4. Emergency Lower Segment Caesarean Section
    • Indications :
      • Fetal distress
      • CPD
      • Umbilical cord prolapse
      • Placenta abruptio
      • Placenta praevia
      • Failed instrumental delivery
      • Failed IOL
  • 5. Elective Lower Segment Caesarean Section
    • Indications :
      • 2 / > previous Caesarean sections
      • A previous classical Caesarean section
      • CPD
      • Placenta praevia
      • Breech presentation
      • Multiple pregnancy
      • IUGR
      • Tumours
  • 6. Upper Segment Caesarean Section
    • avoided unless..
    • Indications :
      • Inaccessible lower segment(fibroids)
      • Impacted transverse lie
      • Major placenta praevia
      • Ca of cervix (prior to performing radical hysterectomy)
      • Post-mortem Caesarean section
  • 7. Procedure
    • Anesthesia
    • Abdominal incision
    • Uterine incision
    • Amniotic sac incision
    • Delivery of baby
    • Umbilical cord clamped
    • Delivery of placenta
    • Stiching of uterus
  • 8.
    • Anesthesia
    • Elective
      • -regional anesthetics (spinal/epidural)
      • -numbs only the lower portion of the body
    • Emergency
    • - Spinal/GA
    • - effect faster
    1. Anaesthesia
  • 9. 2. Abdominal Incision
    • Elective
      • Horizontal/transverse/ Pfannenstiel incision across the abdomen, just above the pubic area.
    • Emergency
      • prefer a vertical cut, from below the navel to just above the pubic area.
    Transverse (Pfannenstiel) Vertical
    • More popular
    • Limited exposure
    • Hernia less common
    • Less popular
    • Rapid entry and good exposure
    • Hernia more common
  • 10. 3. Uterine incision
    • The sheath, then muscles of the uterus are separated, producing a hole for the delivery of the baby.
    • The incision can be either vertical incision or horizontal incision.
  • 11. 4. Amniotic sac incision
    • Cutting through the amniotic sac
    • The amniotic fluid is allowed to escape
  • 12. 5. Delivery of baby
    • Delivery of baby
    • With one hand, the surgeon reaches into the uterus and lifts the baby's head.
    • An assistant pushes down on the mother's upper uterus to help guide the baby out
  • 13. 6. Umbilical cord clamped and cut
  • 14. 7. Delivery of placenta
    • Delivery of placenta
      • controlled cord traction
  • 15. 8. Stitching
    • uterus is stitched closed (with dissolvable stitches),
    • inspect the ovaries and tubes,
    • then close the different tissue layers and put staples or stitches into the skin.
    • Stitch 3 layers for upper segment (thicker) and 2 layers for lower segment.
  • 16. Complications
    • MATERNAL
    • Infection. (genital tract, UTI, wound)
    • Bleeding.
    • Injury to bladder and bowel.
    • Anesthesia complication.
    • Thromboembolism.
    • Next delivery
    • Uterine rupture
    • Placenta previa
    • Placenta accreta
  • 17. Complications
    • BABY
    • Premature birth.
    • Breathing problems.
    • Low Apgar scores.
    • Fetal injury.
  • 18. Advantages
    • MATERNAL
    • -Reduced uterovaginal prolapse
    • -Reduced urinary incontinence
  • 19. THANK YOU