13084782 Cesarean Section

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Cesarean Section



A Cesarean section (or Cesareansection in American English), also known

as C-section or Caesar , is

a surgical procedure in which incisions are

made through a

mother's abdomen (laparotomy)

and uterus(hysterotomy) to deliver one or

more babies.

http://en.wikipedia.org/wiki/American_English

http://en.wikipedia.org/wiki/Surgery

http://en.wikipedia.org/wiki/Incision

http://en.wikipedia.org/wiki/Abdomen

http://en.wikipedia.org/wiki/Laparotomy

http://en.wikipedia.org/wiki/Uterus

http://en.wikipedia.org/wiki/Hysterotomy

http://en.wikipedia.org/wiki/Infant

http://en.wikipedia.org/wiki/Infant

http://en.wikipedia.org/wiki/Hysterotomy

http://en.wikipedia.org/wiki/Uterus

http://en.wikipedia.org/wiki/Laparotomy

http://en.wikipedia.org/wiki/Abdomen

http://en.wikipedia.org/wiki/Incision

http://en.wikipedia.org/wiki/Surgery

http://en.wikipedia.org/wiki/American_English



3

According to incision made:1. Classical

incision made vertically through both theabdominal skin and the uterus.

Advantage is that it is high the uterus soit can be used with a placenta previa to

avoid cutting the placenta, disadvantageis that it leaves a wide skin scar and runsthrough the active contractile portion of

the uterus. Because this type of scarcould rupture during labor, it is likely

that the woman will not be able to have asubsequent vaginal birth



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2. Low segment

Incision made horizontally across theabdomen just over the symphysis

pubis and also horizontally across theuterus just over the cervix. Most

common type of incision currentlymade; also termed as Pfannestiel

incision or bikini incision because evena low-cut bathing suit would cover it



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According to emergence:

1. scheduled2. Emergency – for placenta previa,

abruptio placenta, or fetal distress



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1. Stress response2. Interference with body defenses3. Inerference with circulatory function4. Interference with body organ

function5. interference with self-image or self-esteem



Preperative interview:

1. Any past surgery

2. Secondary illnesses

3. Currently taking any medications

4. Any allergies to foods or drugsThis is to help establish surgical risk

Other:

5. woman’s knowledge about the procedure

6. Length of ospitalization that will be required7. Postsurgical equipment will be used such as an IV

or IC



Establishing Operative Risk1. Poor nutritional status – obese

mothers are at risk because suchcondition interferes wound healing

2. Age – young adolescent and thosethat are 35 years old above

3. General health – persons with

secondary illness (DM, anemia, etc.)4. Fluid and electrolyte balance -

5. Psychological condition



Surgical Procedure:1. Transport from stretcher to the OR table

2. Administration of anesthesia – nurse helps inpositioning the patient***curved back

3. Skin preparation – extends from under thebreasts down to the thighs includes pubic

hair – shave with smooth strokes4. Surgical incision – helps in draping the client



Labor isn't progressing. Stalled labor isthe most common reason for a C-section.Perhaps the cervix isn't opening enough

despite strong contractions over severalhours. Or the baby's head may simply betoo big to pass through the mother’s birth

canal.



The baby's heartbeat suggests reduced oxygensupply. If the baby isn't getting enough oxygen

or your doctor is concerned about changes in

your baby's heartbeat, he or she mayrecommend a prompt C-section.



If the baby is in an abnormalposition. A baby whose feet or

buttocks enter the birth canal beforethe head is in the breech position. If thedoctor isn't able to move the baby intoa more favorable position before laborbegins, patient may need a C-section to

reduce the risk of complications. A C-section is also needed if your baby islying horizontally across your uterus.



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If carrying twins, triplets or othermultiples.

When carrying multiplebabies, it's common for one or more ofthe babies to be in an abnormal

position…



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There's a problem with yourplacenta. If the placenta detaches from

your uterus before labor begins(placental abruption) or the placenta

covers the opening of your cervix(placenta previa), C-section is often the

safer option.



15

There's a problem with the umbilicalcord. A C-section may be

recommended if a loop of umbilicalcord slips through your cervix ahead ofyour baby or if the cord is compressed

by the uterus during contractions.



16

There's a problem with the umbilicalcord. A C-section may be

recommended if a loop of umbilicalcord slips through your cervix ahead ofyour baby or if the cord is compressed

by the uterus during contractions.



17

Your baby is very large. Somebabies are simply too big to safelydeliver vaginally. Typically this isonly a factor if you have diabetes.





19

Your baby has a health problem. A C-section may be safer for babies with

certain developmental problems, suchas failure of the spine to close properly

(spina bifida) or excess fluid in thebrain (hydrocephalus).



20

You've had a previous C-section. Depending on the type of

incision and other factors, you may be

able to attempt a vaginal delivery aftera previous C-section. In some cases,

however, your doctor may recommenda repeat C-section.



21

Risk for the baby:Breathing problems. Babies born by C-

section are more likely to develop abreathing problem marked by abnormally

fast breathing during the first few days afterbirth (transient tachypnea). Elective C-

sections done before 39 weeks of pregnancyor without proof of the baby's lung maturity

may increase the risk of other breathingproblems, including respiratory distress

syndrome.



22

Fetal injury. Although rare,

accidental nicks to the baby'sskin can occur during surgery.



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FOR THE MOTHER

Inflammation and infection of themembrane lining the uterus.This

condition â €” known as endometritisâ €” may cause fever, chills, back pain,foul-smelling vaginal discharge anduterine pain. It's often treated with

intravenous (IV) antibiotics.



24

Increased bleeding. You maylose more blood with a C-

section than with a vaginalbirth. However, bloodtransfusions are rarely

needed.



25

Urinary tract infection. Youmay develop a urinary tract

infection in the bladder orkidneys.



26

Decreased bowel function. Anyabdominal surgery slows the

movement of waste material throughyour intestines. Some medications forpain relief may further contribute to

this problem, leading to constipation.



27

Reactions to anesthesia. Afterregional anesthesia, a small

number of women may

experience a headache caused bya leak of the fluid around the

spinal canal into the tissues of the

back. Allergic or adverse reactionsto the anesthetic also are possible



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Blood clots. The risk of developing ablood clot inside a vein â €” especially

in the legs or pelvic organs â €” is aboutfour times greater after a C-section

than after a vaginal delivery. If a bloodclot travels to your lungs (pulmonary

embolism), the damage can be life-threatening. Your doctors will take

steps to prevent blood clots. You canhelp, too, by walking frequently soon

after surgery.



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Wound infection. Aninfection at or around the

incision site is possible. Whena wound is infected, it mayopen at the skin and release

pus.





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Increased risks during futurepregnancies. After a C-section, you

face a higher risk of potentially serious

complications â €” including bleeding,placenta previa, abnormal fetalpositions and tearing of the uterus

along the scar line from the prior C-

section (uterine rupture) â €” in asubsequent pregnancy than you would

after a vaginal delivery.



Maternal and child health nursing byPhiliterri

http://www.mayoclinic.comhttp://www.en.wikipedia.com

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13084782 Cesarean Section

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