Cesarean section - Causes, symptoms and treatment. MF.

Indications for operation Cesarean section

Caesarean section is a surgical procedure used to extract a child through a cut in the abdominal wall and uterus if labor through natural ways is considered too difficult and dangerous for the mother and / or child.

Before the onset of an independent birth, cesarean section is done for women:

• with an anatomically narrow pelvis or a tumor of its bones;
• if bleeding is detected with placenta previa or if the normally located placenta has prematurely flaky;
• if in a bad state the postoperative scar on the uterus;
• if the fetus experiences an acute shortage of oxygen( hypoxia);
• if the mother suffers from severe non-treatable toxemia( late gestosis);
• if a woman has heart disease, severe hypertension, bronchial asthma, diseased kidneys;
• if the future mother has high degree of myopia( more than 5 diopters) and there is a danger of a serious complication - retinal detachment and blindness( in this case it is important to exclude attempts).

Very often the planned cesarean section is carried out according to the so-called combined indications. What does it mean?

For example, the first birth is due to an "elderly" woman( from 28 years and older) according to obstetric canons. The age itself is not yet the reason: many "age-related primiparous" cope on their own, although not as easily as it happens in 20-25 years. And if the pregnancy is still over, the fetus is large, then in the appendage by the age it is quite likely the occurrence of trouble during childbirth. Childbirth can be protracted, the child will not have enough oxygen and there is a possibility that he may die. In addition, by the age of 30 many abortions have already been done, others have been treated for a long time from infertility or have already acquired any chronic diseases. What if this pregnancy is the only one that you managed to keep and report to the end? Then the question of whether or not this woman is a mother, depends entirely on the mode of delivery. ..

By the way, cesarean section is almost always inevitable in view of numerous abortions. After them, dystrophic and cicatricial changes are formed in the uterus, inflammatory processes occur - and the consequence of abortion drags into pregnancy: placental insufficiency, weakness of labor, hypoxia of the fetus. ..

Cesarean section duration

The operation lasts for about an hour, the second one lasts longer. Already in the 10-15 minute from the beginning of the operation the fetus is removed and it is out of danger.

How to behave after the operation

If the operation has ended without complications, after a few hours you can turn in bed, move your legs, and the next day - sit down and walk around the ward. You can feed the baby 2 hours after the operation. On the 6th-7th day, the sutures will be removed from the abdominal wall and the mother and child will be discharged home under the supervision of the doctor of the women's consultation. However, the healing of the sutures on the uterus and the wall of the abdomen is still going on, and you will have to be cautious. Do not remove the baby from a low crib or stroller( you can take it from a changing table and keep it on your hands).In the first 2-3 months, do not lift anything heavier than 5 kg.

Probably, within a month or even a few, there will be a slight pulling pain in the lower abdomen. It is associated with contraction of the uterus and healing of the scar.

If suddenly you feel a sharp pain, if there are again abundant bloody, pus-like discharge from the vagina, if the temperature rises - immediately contact a women's consultation. It is possible that endometritis - inflammation of the uterine mucosa has developed, and urgent treatment is required.

The healing of the suture in the anterior abdominal wall is usually smooth and painless. Only in very rare cases it becomes inflamed, it begins to fester. Then it is urgent to the surgeon - it is impossible, that the inflammatory process has passed into the depth of the abdomen, to the underlying tissues.

When it is possible to give birth after surgery, cesarean section of

During the next 2-3 years, neither birth nor abortion is desirable. In the first case, the scar on the enlarged uterus can not be completely formed, and complications will arise again;and with abortion there is a danger of perforation of the uterus where the former incision is located.

Therefore, soon after the operation it is necessary to decide with a gynecologist what method of contraception is best to apply.

Almost all women who have undergone a cesarean section can and should, for safety reasons, continue to give birth in the natural way, if there is no contraindication to this. However, when the indications for the delivery are preserved, it is possible to have two or more cesarean sections with a high percentage of successful outcomes.

Anesthesia during caesarean section

For anesthesia, as with any abdominal surgery, the pregnant woman gets anesthesia.

Epidural anesthesia: Anesthetic is injected into the so-called epidural space of the spinal cord in the lumbar region. The pain is removed in the lower part of the body, you can even talk with your mother.

Epidural anesthesia with caesarean section

Usually, an epidural anesthetic is performed for anesthesia during a caesarean section. Epidural anesthesia is usually performed when the mother is sitting directly or lying on her side curled up, so that the anesthetist has optimal access to the spine. If the trial dose is successful, then in the epidural space, a catheter is usually left, through which, as necessary, a drug is added, the dose of which varies as needed. The procedure itself is described by a variety of epithets, from "unpleasant" to "very painful."

Often because of labor, a woman in labor can be very difficult to bend. Local anesthesia is more painful than the introduction of the epidural needle, because at the time of insertion of the needle the parturient does not feel anything. Most women feel at this moment "push and tingle".In rare cases, the needle can catch the nerve, which causes a leg cramp or sudden "shooting" pain. This is normal and does not mean that you are paralyzed.

The feeling of the parturient woman after anesthesia depends on the combination of the medicine, the stage of labor and many other factors. Some women feel contractions, but do not feel their pain. Others remember that they felt absolutely nothing - from their nipples to their knees their body was numb. Be sure to discuss with your anesthesiologist your possible feelings, so that they do not become a surprise for you.

After the appearance of the baby, remove the catheter and fixing it with an adhesive tape. However, even after that, the mother can feel the numbness of her legs for several hours. In rare cases, the period of numbness can last for a longer time. It does not exclude pain in the place where the needle is inserted.

Much less often use intubation( endotracheal) anesthesia: a breathing tube is inserted into the breathing tube, through which oxygen enters with nitrous oxide. Before the extraction of the fetus, the woman is spared anesthesia with the minimal doses. Only when the child is separated, they give a deep anesthesia - the operating field still needs to be closed. Currently, make a transverse suprapubic seam length of about 12 cm, such a seam better heals and looks great in a cosmetic way. In case of urgent surgery, the incision can be made from the navel vertically downwards.