Obstetric and Gynecology Collective Notes

Summary:

Cesarean Section (C-section) is a surgical delivery of the fetus through incisions in the abdominal and uterine walls, performed when vaginal delivery is not feasible or poses risks. The procedure’s primary types are primary, secondary, or repeat cesarean sections, with some being elective and scheduled, while others are unscheduled and performed for various maternal and fetal indications. The global cesarean rate has risen to over 20%, attributed to factors like avoiding mid-forceps and vaginal breech deliveries, increased fetal monitoring, and the belief that multiple pregnancies after a cesarean must be delivered the same way. Common indications include previous cesarean, breech presentation, dystocia, and fetal distress, while contraindications are the absence of appropriate reasons. Adequate investigations, like CBC and blood typing, are performed upon admission, and cesarean sections are crucial when necessary, but efforts to reduce rates and promote safe vaginal deliveries are essential.

Excerpt:

Obstetric and Gynecology Collective Notes

CESAREAN SECTION
Definition:
 The term “cesarean section” denotes the delivery of the fetus, placenta, and membranes through a surgical incision in the abdominal (laparotomy) and uterine walls (hysterectomy).
 This definition excludes the obsolete operation of vaginal cesarean section in which transvaginal access to the fetus is achieved by incising the anterior lip of the cervix and lower uterine segment.
 The term also excludes the operation involving the recovery, through an abdominal incision, of a fetus lying free in the abdominal cavity after secondary implantation or uterine rupture.
 The correct term for the surgical delivery of a pre-viable infant is hysterotomy.

Classification
 The first cesarean section performed on a patient is known as a primary cesarean section; subsequent procedures are referred to as secondary, tertiary, and so on, or simply as repeat cesarean sections.
 An elective cesarean section is performed before the onset of labour or before the appearance of any complication that might constitute an urgent indication.
 CDs may be scheduled (no labour, elective, planned) or unscheduled (during labour, nonelective, unplanned) and are performed for both maternal and fetal indications.
 Classic cesarean section is in which the uterine incision is made in a longitudinal direction through the corpus uteri.