- delivery of a fetus by incision through the abdominal wall and uterus
Types of Caesarean Section LSCS (Lower segment Caesarean section) Upper segment / Classical Caesarean section
- Transverse incision over the lower segment of the uterus
- Does not take an active part in contraction and retraction during labour
- Access to the presenting part of the fetus
- Vertical incision over the fundus and body of the uterus
- Takes an active part in contraction and retraction during labor
- Does not give access to the presenting part
Emergency Lower Segment Caesarean Section
- Failed instrumental delivery
Elective Lower Segment Caesarean Section
- 2 / > previous Caesarean sections
- A previous classical Caesarean section
Upper Segment Caesarean Section
- Inaccessible lower segment(fibroids)
- Ca of cervix (prior to performing radical hysterectomy)
- Post-mortem Caesarean section
- -regional anesthetics (spinal/epidural)
- -numbs only the lower portion of the body
2. Abdominal Incision
- Horizontal/transverse/ Pfannenstiel incision across the abdomen, just above the pubic area.
Transverse (Pfannenstiel) Vertical
- prefer a vertical cut, from below the navel to just above the pubic area.
- Rapid entry and good exposure
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.
4. Amniotic sac incision
- Cutting through the amniotic sac
- The amniotic fluid is allowed to escape
5. 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
6. Umbilical cord clamped and cut
7. Delivery of placenta
- 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.
- Infection. (genital tract, UTI, wound)
- Injury to bladder and bowel.
- -Reduced uterovaginal prolapse
- -Reduced urinary incontinence