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Summary Cesarean Section

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A 1-4 page document written by a final year medical student with distinction grades in the uploaded modules. These notes are concise and of very high quality - using a combination of textbooks, lectures, and current guidelines (NICE and RCOG). These documents are the only resource you should need f...

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  • December 19, 2018
  • 3
  • 2017/2018
  • Summary
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Caesarean Sectin
C-sectio = Delivery if a fietus via the abdiminal riute (laparitimy) requiring an incisiin inti the uterus
(hysteritimy)

Epidemiiligy
 2nd mist cimmin surgical pricedure (behind male circumcisiin)
 Acciunts fir 20-25% if all deliveries in the UK
 30% if C-sectins are electve repeat pricedures
 Maternal mirtality frim C-sectin is liw (<0.1%), but it is stll higher than mirtality frim vaginal births

Indicatins
Absilute Relatve
Materoal Emergency - Electie -
 Failure ti prigress (labiur dysticia)  Priir C-sectionRepeat (30% if all
Electie – C-sectins)
 Uotreated STI e.g. herpes, HIV,  Materoal disease (previius
ginirrhiea preeclampsia, cardiac disease,
diabetes, cervical cancer)
Uteriplaceotal Emergency - Electie -
 Placeota previa  Priir uterioe surgery (full-thickness
 Placeotal abruptio myimectimy)
 Previius uterioe surgery  Multple pregoaocy
Electie -
 Priir uterioe rupture
 Large fbriids
Fietal Emergency - Electie -
 Fietal distress  Fietal malpreseotatio (breech,
 Cird prilapse briw, cimpiund)
Electie -  Macrisimia
 Fietal malpreseotatio (transverse lie)  Fietal aoimaly (hydricephalus)

Pricedure
 If electve - can be perfirmed after wee 罢9
 Pre-ip
- Riutne priphylactc aobx ti decrease risk if puerperal sepsis
- Catheter inserted
- IV line
- Regiioal aoaesthesia (ir GA if nit wirking)
 Abdi iocisiio (tme frmm nncninmn om bnroi ni t5mnnin
- PFANNESTIEL INCISION
o Liw transverse incisiin
o Incisiin made 1-2cm abive pubic crest, and 10-14cm ling.
o May be midifed as Maylard (slightly higher, and invilves hirizintally
dividing rectus muscles) ir Cheroey incisiin (lifing rectus if pubic bine)
o Advantages - Muscle separated, heals stringer, cismetc
o Disadvantages - Limited expisure
- MIDLINE VERTICAL INCISION
o Vertcal incisiin ti lef side if umbilicus (ti aviid cutng ligamentum teres)
o Only indicated if:
 Emergency (quicker)
 Ni access ti liwer segment (e.g. adhesiins, fbriids)
 Piirly develiped/ni liwer segment (e.g. very preterm birth, preterm breech)

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