Cesarean Section

Cesarean section refers to delivering the fetus, placenta, and fetal membranes through an abdominal and uterine wall incision. Cesarean section can be elective or emergency.

Indications of cesarean section

• Cephalopelvic disproportion- a risk factor for difficult labor
• Previous maternal scars- in fear of trial of scar(TOS)
• Malpresentations
• Malpositions
• Fetal death
• Placenta previa
• Abruption placenta
• Intrauterine growth restriction
• Bad obstetric history
• Failed induction of labor

Techniques of cesarean section

1. Classical

–Less common

-In this technique, a vertical incision is made in the anterior aspect of the uterus.

Indicated in;

• Lower uterine segment adhesion
• Lower uterine segment tumors, e.g., fibroids
• Transverse lie- especially with ruptured membranes
• Abnormal vasculature of the uterus
• 2. Lower uterine segment cesarean section (LUSCS)

-In this technique, the patient lies supine on the operating table, and preoperative preparations are made.

-Spinal anesthesia is administered. Aseptic criterion is followed, and an incision, preferably a Pfannenstiel incision, is made in the lower abdomen. Upon reaching the uterus, a lower segment incision is made.

Advantages over classical technique

• Has better healing
• Has low risks of infection s the area is extraperitoneal
• Low risk of uterine rupture in subsequent pregnancies

Complications of cesarean section

• Postpartum hemorrhage
• Fetal injury
• Surgical site infections
• Wound dehiscence
• Transfusion reactions- when blood is transfused in excessive blood loss