14 - Obs - Instrumental and Operative Delivery - C/S Flashcards
Classic c-section is what? when is this indicated? (3 things)
vertical uterine incision
if fetus transverse, multiple fibroids, extreme prematurity
Common reasons for emergency Cs - 2
Common reasons for elective Cs - 2
Failure to progress in labour
fetal distress
prev C/S
breech presx
Absolute indications for elective C/s
- ??
- severe antenatal ? compromise
- ? abnormal lie
- prev ? c sec
- gross ? deformity
PP fetal uncorrectable vertical/classical pelvic
Relative indications for elective cs
- ? presx
- severe ????
- ?
- ??/other medical problems
- prev cs
- ? ? women
breech IUGR twins DM older nulliparous
CS - definition of type/urgency
- emergency - ? threat to mother or fetus eg severe ? ?
- urgent - maternal/fetal compromise not immediately ?-? eg ?
- scheduled - needing ? delivery but no compromise
- elective -at time to suit ? and team
- Peri-postmortem - For fetus and mother during maternal ?/for fetus after maternal ?
immediate fetal distress life-threatening dystocia early mother arrest death
Maternal complx
? and need for transfusion, infection of ?/?, rare visceral eg ? or ? damage, post-op pain and ?, and ???. Prophylactic ? reduce incidence of infection, ?measures routine. 1/5000 ?
rate.
haemorrhage wound/uterus bladder bowel immob VTE Abx thromboprophylactic death
Fetal Complx
Elective: incr risk of fetal ?
morb at any ?, so if uncompx not before ?wks. Still occurs in 4%. Fetal ? rare/minor. ? and ? esp affected by emergency procedure.
resp gestation 39 lacerations bonding BFeeding
Complx - Subsequent pregs
- no ? to CS’s - but get more ?
- small incr in ? in next preg
- incr risk of ?? next preg - also ? and ? may occur
limit difficult stillbirth PP accreta percreta
