Cesarean Section

Question 1

Cesarean section

Answer 1

It is an operative procedure whereby the fetus after end of 28w are delivered through an incision on the abd & uterine wall.

Question 2

Cause of increasing incidence of CS

Question 3

Relative indication

Answer 3

1. Cephalopelvic disproportion
2. Dystocia d/t 3ps relatively large fetus (passenger) , small pelvis (passage) , insufficient uterine contraction (power)
3. Fetal distress
4. Malpresentation- breech transverse lie brow
5. APH- placenta previa abruptio placenta
6. Failed IOL, failure to progress in labour
7. Bad obs history recurrent fetal loss
8. Medical-gynecological disorder: uncontrolled diabetes, mechanical obstruction - pelvic tumors or following repair of vesicovaginal fistula
9. Severe PE eclampsia
10. Previous CS - previous 2 CS, features of scar dehiscence, previous classical CS

Question 4

Absolute indication

Answer 4

1. Central placenta previa
2. Contracted pelvis
3. Pelvic mass causing obstruction - cervical or broad ligament fibroid
4. Advanced Ca CX
5. Vaginal obstruction (atresia,stenosis)

Question 5

Elective CS
Emergency CS

Answer 5

Operation done at prearranged time during pregnancy to ensure best quality of obstetrics, anesthesia, neonatal resuscitation & nursing services.
Benefit- reduce perinatal morbidity & mortality, no pelvic floor dysfunction
Risk- longer recovery time & hospital stay, risk of placenta previa & hysterectomy

Operation done d/t an acute obstetrics emergency
Cat 1- immediate life threat of mother or fetus. Decision interval 30 mins
Cat 2- maternal or fetal distress no immediate threat to life . Dicision interval 75min
Cat 3- no maternal & fetal compromise bt needs early delivery
Cat 4- planned to suit the women family members & hospital staff