C-Section

1. CAESAREAN SECTION

2. DEFINITION
oIt is an operative procedure whereby the fetus
after the end of 28th week are delivered through
an incision on the abdominal and uterine walls

3. TYPES OF OPERATION
o Classical or upper segment caesarean section
o Lower segmented caesarean section

5. INDICATIONS FOR C/SECTION
Absolute indications
o Cephalo pelvic disproportion
o Major degrees of placenta praevia
o Multiple pregnancy
o Carcinoma of cervix
o Fibroids
o Failed induction
o Cord presentation/prolapse
Relative indications
o PIH
o Malpresentation
o Medical gynaecological
conditions
o Previous scar
o APH
o Bad obstetrical history

6. TYPES OF OPERATION
o According to Timing
o Elective caesarean section
o Emergency caesarean section
o According to gestational age
o Hysterotomy – before term
o C/section – at term

7. CONTRAINDICATIONS
o Dead fetus
o Baby, too mature to survive outside the uterus
o Presence of blood coagulation disorders

8. COMPLICATIONS
o INTRAOPERATIVE
o Extension of incision
o Bladder injury
o GI tract injury
o Haemorrhage
o POSTOPERATIVE
o Immediate
o PPH- post partum haemorrhage
o Shock
o Anesthesia hazards
o Infection
o Intestinal obstruction
o Deep vein thrombosis
o Wound complication

9. COMPLICATIONS
o Remote
o Menstrual irregularities
o Chronic pelvic pain or back pain
o Incisional hernia or obstruction
o Risk for scar rupture in future pregnancy
o Fetal complications
o Iatrogenic prematurity
o Respiratory distress

10. CAESAREAN HYSTERECTOMY
o Caesarean hysterectomy refers to an operation where caesarean section is
followed by removal of the uterus.
o Conditions are
o Atonic uterus or uncontrolled PPH
o Morbid adherent placenta
o Big fibroid
o Extensive laceration
o Infected uterus
o Rupture of uterus with fetus inside