Cesarean birth

Cesarean birth

Cesarean section is needed for delivery in 25-30% of ladies.

There are many indications for cesarean birth.

Cesarean birth has many benefits, yet it also has many disadvantages.

Indications for cesarean birth:

** breech presentation

** previous cesarean birth

** pre-eclampsia with unfavorable cervix

** chorioamnionitis

** active genital herps/warts

** multiple pregnancy

** placenta previa

** placenta accreta

** fetal distress

** cephalopelvic disproportion

** slow progression of labor

** maternal choice after full counselling

Complications of cesarean birth:

** bleeding

** the need for blood transfusion

** ICU admission

** neonatal ICU admission

** placenta previa and accreta in future pregnancies

** more postpartum pain

** infection

** formation of future adhesions with subsequent infertility

** stress urinary incontinence

What to do to reduce the rate of infection?

Give intravenous antibiotic prophylaxis 30 minutes before skin incision

How do we reduce the risk of thrombosis after cesarean section?

** early ambulation

** encourage hydration

** anticoagulation

Which mode of anesthesia is better for cesarean section?

The mode of anesthesia is determined according to many factors, but generally spinal anesthesia is preferred.

how is pain managed after cesarean section?

** intramuscular analgesia or intravenous analgesia:

• Narcotics
• NSAIDS
• Paracetamol

** patient-controlled analgesia through special devices

For how long do we keep the urinary catheter after cesarean section?

Depending on the case, usually it is removed 6-8 hours for early ambulation

What is the length of hospital stay after cesarean section?

usually, 24-48 hours but might be longer depending on the case itself

wound care after cesarean section:

• Daily showers with water and soaps to keep the wound clean
• Avoid excessive sweating
• Wear loose cotton clothing
• Avoid heavy lifting or straining
• Take antibiotics as prescribed
• Monitor for any change in wound color or foul-smelling discharge

Dr Najeeb Layyous  F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist