Caesarean section is a surgical procedure to deliver fetuses after 28 weeks of gestation through an incision in the abdominal and uterine walls. A primary caesarean section refers to the first operation on a patient, while repeat caesarean sections are performed in subsequent pregnancies. The incidence of caesarean sections is rising due to factors like identifying at-risk fetuses and mothers earlier, and wider use of repeat caesarean sections. Caesarean sections are indicated when vaginal delivery is contraindicated or unsafe for the fetus or mother, with common indications including cephalopelvic disproportion, fetal distress, and previous caesarean delivery.

1. CAESAREAN SECTION

2. DEFINITION
It is an operative procedure whereby
the fetuses after the end of 28th week
are delivered through an incision on
the abdominal and uterine wall.

3. Primary caesarean section
The First operation performed on a
patient is referred to as a primary
caesarean section

4. REPEAT CAESAREAN
SECTION
When the operation is performed in
subsequent pregnancies, it is called
repeat caesarean section.

5. INCIDENCE
• Approximately – 10%
• But the incidence of C.S. is steadily rising,
the other responsible factors are :
• Identification of at risk fetuses before term
• Identification of at risk mother
• Wider use of repeat C.S. in case with
previous caesarean delivery
• Elderly primigravidae

6. INDICATION
C.S. Is done when labour is
contraindicated or vaginal delivery
is unsafe for fetus or mother

7. Common Indication
• Cephalopelvic disproportion
• Fetal distress
• Previous caesarean delivery
• APH
• Malpresentation

8. Absolute Indication
• Vaginal delivery is not possible C.S. is
needed even with a dead fetus.
• APH
• Contracted pelvis
• Cephalopelvic disproportion
• CA of cervix
• Vaginal obstruction

9. Relative Indication
• Vaginal delivery may be possible but more
risk to mother and fetus.
• Previous caesarean delivery.
• APH
• Malpresentation
• Bad obstetric history
• Hypertensive disorders
• Medical – gynaecological disorder

10. Time of Operation
• Elective
When the operation is done at a
prearranged time during pregnancy to
ensure the best quality of obstetrics,
anesthesia, neonatal resuscitation and
nursing services.

11. Maturity is Certain
• The operation is done about one week prior to
the EDD
Maturity is uncertain
• Ultrasound assessment in first or second
trimesteres to ensure fetal maturity.
• Otherwise spontaneous onset of labour is
awaited and then C.S is done.
Emergency
• When the operation is should be performed in
acute obstetric emergencies within the 30 min
the procedure should be started.

12. Type of Operation

13. LSCS
• In this operation, the extraction of the baby is done
through an incision made in the lower segment through
a transperitoneal approach
Classical
• In this operation, the baby is extracted through an
incision made in the upper segment of the uterus.
Indication
• Serve contracted pelvis
• Big fibroid on the lower segment
• CA of cervix
• Postmortem section

14. Complication of C.S.
• Intra Operative Complications
• Extension of uterine incision to one or both the
sides. This may involves the uterine vessels to
cause severe hemorrhage, may lead to broad
ligament haematoma formation.
• Uterine lacerations at the lower uterine incision
• GI tract injury
• Postpartum hemorrhage

15. Post Operative Complications
• Maternal
• Immediate : PPH
Shock
Infection
Intestinal obstruction
Wound Complication
 Remote : Gynaecological
General surgical Future
pregnancy.
 Fetal Asphyxia
RDS
Prematurity
Intra Cranial hemorrhage