Caesarean section

What is a cesarean section?

Caesarean section is the delivery of the child through the mother's abdomen by making an incision (wound) in this wall (laparotomy) and uterus (hysterectomy).

Normally a transverse abdominal incision is made in the lower abdomen and that although it is technically more difficult be offset by more aesthetic.

The relative safety of the Caesarean increased the percentage of births that ended this procedure. It is estimated that between 10 and 20% of all births are by cesarean section. But the fact of not being free of hazards (loss of health and even life of the mother) and that complications occur more frequently during Caesarean section with vaginal delivery, only practice makes indicated cesarean when there is a strict medical indication.

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A C-section may be planned in advance (elective), or when a problem of maternal or fetal health and advises or may arise the need to perform caesarean section more or less immediate complications or difficulties in childbirth form. Elective caesarean is usually done one or two weeks before the expected date of birth. This ensures that the baby is sufficiently developed and mature to live alone outside the womb.

Elective caesarean section or one that is programmed in advance for a particular date

• When there is a history of two previous cesarean sections or individual interventions scars on the uterus where this is fully opened.
• The placenta is placed on the outlet of the uterus thereby preventing vaginal birth of the child. This is called placenta previa .
• When the obstetrician or midwife before delivery discovers a situation that potentially threaten the child's life from lack of oxygen if you are expose himself to labor.
• When coexisting with pregnancy maternal disease such that the effort it demands labor can unbalance or worsen their health (eg, heart failure, moderate or severe).
• If because the big boy (macrosomia), present it any malformation or the maternal pelvis is too narrow or deformed the possibility of a vaginal delivery is presumed impossible (situation called cephalic-pelvic disproportion).
• Current or very recent infection of the external genitalia by herpes virus , trying to avoid transmission to the fetus during passage thereof through the vagina.

Epidural, yes or no?

The epidural anesthesia is safe and reliable, but not without risks. Read about it.

Urgent cesarean indication during pregnancy or childbirth

• When the placenta detaches from the uterus still widely it is finding the child within the same (early detachment of normally inserted placenta).
• If severe vaginal bleeding occurs and it is expected that delivery can not happen immediately.
• Seizure of pregnancy ( eclampsia ).
• Sudden departure of the uterus cord standing in front of the child's head, a situation that is called cord prolapse.
• Suspected uterine rupture before labor or during delivery if rapid expulsion of child vagina is not expected.

Indication of cesarean delivery during

• Child misplaced (eg transversely located).
• If no expansion, despite having the appropriate stem for a reasonable time contractions.
• Failure stimulation of labor with oxytocin (hormone substance commonly used to produce uterine contractions).
• Disproportion between maternal pelvis or suspected fetal head during childbirth.
• Signs of fetal distress that does not yield to treatment.
• Maternal fever during labor, provided it is presumed that vaginal delivery will be slow.
• Sometimes there will be high-risk situations (eg, history of previous stillbirths, first pregnancy at an advanced age, previous sterility treatment, etc.) which, together with the above may establish an indication for cesarean section.

When a cesarean is necessary?

Overall Caesarean sections can be classified into three types:

Women must therefore be aware that CS must always have a medical indication to justify it and never will be performed following the patient without further.

What happens during a caesarean?

In a cesarean is the surgeon and his assistant, anesthetist, the scrub nurse's another nurse, a midwife and pediatrician.

In Spain the presence of the couple or a family member is not permitted during the making of it, even if it is practiced by epidural anesthesia.

An abdominal incision of 15 to 20 cm which can be cross in the lower abdomen and near the (most common) or vertical midline of the abdomen from the navel to the pubic hair pubic hair practice. After the opening of the various layers of tissue that make up the abdominal wall into the uterus leads on which a transverse incision which allows opening and through which the child is extracted practiced. The whole process lasts until birth a few minutes.

After birth, the umbilical cord is cut and the baby to his mother shown, if feasible and it remains awake. After removal of the placenta, the obstetrician closes the incision of the uterus and abdominal wall layer by layer; to reach the skin suture this is usually done with silk sutures visible but there is the possibility that intradermal sutures or staples and calls that go into the skin without being visible in use. Staples or silk must be removed after six or seven days, whereas the intradermal suture is biodegradable does not require removal.

In general, the duration of uncomplicated caesarean section is 30-40 minutes.

What you feel during a cesarean section?

Most anesthetists practice a spinal or epidural anesthesia using a thin needle which is situated in the lower half of the column. Most women will experience a feeling of pressure during cesarean section, but will not feel pain. You may be advised one anesthesia usually in certain circumstances where anesthesia epidural is contraindicated or maternal health status requires it, eg hypotension bleeding.

What are the risks of cesarean section?

A cesarean section is a safe operation for both mother and child. However, as in some surgical operations of importance, there risks. The main ones are for the mother and include severe bleeding during surgery or wound infection of the urinary tract , development of blood clots (thrombosis in the veins of the legs or pelvis) after delivery.

Further complications arise from the use of anesthesia, others are derived from neighboring viscera injury to the uterus (bladder, intestine, ureters). The obstetrician and midwife will ensure appropriate measures to reduce the risk of developing these complications or should be established for healing measures.

What happens after cesarean?

Most of the women get up and stand at 24 hours of CS, which is highly desirable for the prevention of thrombosis by immobility. Wound pain is controlled with the right soothing. Most mothers leave the hospital or clinic 4 or 5 days after cesarean delivery. On the third day postpartum women can receive showers without prejudice to the wound.

A C-section does not prevent a mother feeds her child to breastfeed, if that is your desire. Like after vaginal delivery after cesarean section you can have the "wrongs" which are intermittent pain caused by contraction of the uterus.

In general, the woman reaches her usual pre-pregnancy at six months postpartum weight. Exercise will help the recovery of your figure.

The sex with intercourse may start three weeks fulfilled caesarean section.