CESAREAN SECTION

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CESAREAN SECTION

• Anna Mae Smith, MPAS, PA-C

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Cesarean section

• labor is considered unsafe for either mother or
  fetus
• when delivery is necessary but labor cannot be
  induced
• when dystocia or fetal characteristics present
  significant risks and contraindicate vaginal
  delivery
• when an emergency mandates immediate delivery and
  the vaginal route is not possible or suitable

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Maternal Risks of Labor

• previous myomectomy transecting the uterine wall
• previous uterine reconstruction
• previous repair of a vaginal fistula

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FETAL Risks

• placenta previa
• velamentous insertion of the cord or other forms
  of vasa previa
• cord presentation
• more recent recommendations include treatable
  fetal anomalies such as meningomyelocele and
  certain degrees of hydrocephaly.

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Top Reasons

• Repeat - 33
• Dystocia - 30
• Fetal distress breech, others - remaining

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DYSTOCIA

• Mechanical problems of the uterus, fetus, or
  birth canal that prevent the successful or safe
  progress of labor and vaginal delivery are
  collectively referred to as dystocia

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Absolute Indications

• significant abruption of the placenta
• hemorrhage from placenta previa
• prolapse of the umbilical cord
• active genital herpes
• impending maternal death

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Complications

• Occur in 25-50 of patients
• 1-2 deaths per 1000
• unexplained fever
• endometritis
• wound infection
• Wound dehiscence
• hemorrhage

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Complications cond

• aspiration
• atelectasis
• urinary tract infection
• thrombophlebitis
• pulmonary embolism