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Flashcards in CAESARIAN SECTION Deck (11):
1

What is the classical type of caesarian section?

Midline uterine incision

2

What is the most common type of caesarian section?

Lower segment caesarian section

3

When might the classical type of caesarian section be indicated?

Preterm delivery with a poorly formed lower segment

Preterm abnormal lie

4

Why are classical type caesarian sections rarely used nowadays?

Higher rates of haemorrhage and rupture (5%) in future labours

5

What are the maternal indications for lower segment caesarian section (LSCS)?

Two previous LSCS (out of date now, but still offered)

Placenta praevia

Fulmination pre-eclampsia

Maternal request - anxiety

Active primary genital herpes simplex virus

HIV disease depending on viral load

6

What are the fetal indications for lower segment caesarian section (LSCS)?

Breech presentation or unstable lie

Twin pregnancy when twin 1 presentation is not cephalic

Abnormal CTG in 1st stage of labour

Abnormal FBS in 1st stage of labour

Cord prolapse

Delay in first stage of labour eg due to malpresentation

7

When is an elective caesarian section usually performed?

39 weeks or more

8

Which is more commonly used in caesarian section, general anaesthesia or local anaesthesia?

Local

9

What are the steps of lower segment caesarian section?

Low transverse skin incision

Rectus sheath is cut and muscles divided

Uterovesical peritoneum is incised to allow bladder to reflected inferiorly

Lower uterine segment is incised transversely

Intravenous oxytocin given

Membranes removed

Everything is closed up making sure there is no haemorrhage

10

What are the complications associated with lower segment caesarian section?

Haemorrhage: all patients should be G+S

Gastric aspiration

Visceral injury - damage to bladder, bowel

Infection

VTE

Future pregnancy complications

11

Following a previous caesarian section, what is the success rate of future NVD (also termed VBAC - vaginal birth after caesarian)?

70% almost the same as NVD without previous c-section