Caesarean Section

Question 1

Define a C section

Answer 1

involves delivery of the baby through an incision in the abdomen and uterus. Usually performed under spinal anaesthetic.

Question 2

What are the indications for an elective C sec?

Answer 2

Previous caesarean
Symptomatic after previous perineal tear
Placenta praevia
Vasa praevia
Multiple pregnancy
Uncontrolled HIV
Cervical Cancer

Question 3

What are the 4 categories of indications for an emergency C sec?

Answer 3

Category 1: Immediate threat to life of mother and baby. Decision to delivery time is 30 minutes.

Category 2: No imminent threat to life but required urgently due to compromise of mother or baby. Decision to delivery is 75 minutes

Category 3: Deliver is required but mother and baby are stable

Category 4: Elective Caesarean

Question 4

What are complications associated with surgery in a C sec?

Answer 4

Bleeding
Infection
Pain
Damage to local structures (Ureter, bladder, bowels)

Question 5

What are general complications of a C section?

Answer 5

Aspiration pneumonia
Postpartum haemorrhage
Venous thromboembolism
Risk of lacerations (2%)
Increased incidence of transient tachypnoea of the newborn

Question 6

What is the effect of a future pregnancy if a C section has been carried out?

Answer 6

Increased risk of repeat caesarean
Increased risk of uterine rupture
Increased risk of placenta praevia