c section Flashcards
indications for elective c section
prev CS symptomatic after prev perineal tear placenta praevia vasa praevia breech multiple pregnancy uncontrolled HIV cervical cancer
category 1 cs
immediate threat to life of mum or baby
30mins
category 2 cs
not imminent threat to life but CS urgently required to due mum/baby compromise
75mins
category 3 cs
delivery is required but mum and baby are stable
category 4 cs
elective CS
most commonly used skin incision
transverse lower uterine segment incision
joel-cohen incision
layers of abdomen that go through
skin subcut tissue fascia/rectus sheath rectus abdominis peritinoeum vesicouterine peritoneum uterus amniotic sac
measures to reduce risk during CS
ranitidine or PPI
prophylactic antib
oxytocin to reduce risk PPH
VTE prophylaxis w LMWH
general surgical risks
bleeding
infection
pain
VTE
complications in post-partum period
PPH
wound infection
wound dehiscence
endometritis
damage to local structure - what at risk
ureter
bladder
bowel
blood vessels
effects on future pregnancies
inc risk repeat CS
inc risk uterine rupture
inc risk placenta praevia
risks to babt
risk lacerations
inc risk of TTN
vaginal birth after CS
possible if cause of CS is unlikely to recur
contraindications to vaginal birth after CS
prev uterine rupture
classical CS scar (vertical incision)
other usual contraindications to VB e.g. placenta praevia
