13084782 cesarean section
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Cesarean Section
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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.
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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
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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
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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
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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
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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.
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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.
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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.
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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.
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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.
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Your baby is very large. Somebabies are simply too big to safelydeliver vaginally. Typically this isonly a factor if you have diabetes.
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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).
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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.
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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.
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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.
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Increased bleeding. You maylose more blood with a C-
section than with a vaginalbirth. However, bloodtransfusions are rarely
needed.
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Urinary tract infection. Youmay develop a urinary tract
infection in the bladder orkidneys.
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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.
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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.