Diagnostics
Cesarean Section
What is cesarean section?
Cesarean section, or C-section or Cesarean birth involves surgically delivering a baby through an incision made in the mother’s abdomen and uterus.
Cesarean sections are performed when a vaginal delivery is not feasible or safe or when there are risks to the mother or baby’s health.
Who performs C-section?
C-sections are typically performed by obstetricians or gynaecologists, specialized doctors trained in women’s health and childbirth. These medical professionals have expertise in managing pregnancy, labour, and delivery, including vaginal and cesarean births. These are performed in multi-speciality hospitals and specialized maternity clinics.
Why is cesarean section done?
Various reasons for which C-section is indicated, include:
- Foetal distress: When the baby shows signs of distress during labour or delivery.
- Failure to progress: A C-section may be necessary if labour is not progressing as expected.
- Breech position: When the baby is positioned feet-first or buttocks-first rather than head-first.
- Placenta previa: When the placenta partially or completely covers the cervix, obstructing the baby’s passage.
- Multiple pregnancy: In the case of twins, triplets, or more, a C-section might be the safest delivery method.
- Previous C-section: Women who have had a prior C-section may require a repeat
C-section for subsequent pregnancies.
How is cesarean section performed?
Preparation
- The patient’s medical history and condition are reviewed, and informed consent is obtained.
- The surgical team, including obstetricians, anesthesiologists, nurses, and support staff, assembles in the operating room.
- The patient’s abdomen is cleaned and sterilized, and a sterile drape is placed over the area.
Anesthesia
Anesthesia is administered to ensure that the patient is comfortable and pain-free during the procedure. This can be done using regional anesthesia (epidural or spinal block) or general anesthesia, depending on the circumstances.
Surgical incision
A surgical incision is made in the abdomen to access the uterus. The most common incision is a low transverse (horizontal) incision just above the pubic bone, which is preferred for reducing the risk of complications in future pregnancies.
Uterine incision
An incision is made in the uterus to access and deliver the baby. The most common uterine incision is also low transverse, though sometimes a vertical incision may be used.
Delivery of the baby
The baby is carefully delivered from the uterus. This may involve gentle pushing, pulling, or a combination of both.
Cord clamping and baby care
After the baby is born, the umbilical cord is clamped and cut. The baby is given initial care and assessment by a pediatrician or neonatal specialist.
Placenta removal
The placenta is removed from the uterus, and the surgeon checks to ensure there is no remaining tissue.
Uterine closure
The uterine incision is closed using sutures.
Abdominal closure
The abdominal incision is closed with sutures or staples, depending on the surgeon’s preference.
Post-operative care
The patient is monitored in the recovery room, where vital signs and the incision site are closely observed.
Pain management and wound care are addressed, and breastfeeding can often begin soon after the procedure
As with any surgical procedure, a C-section carries certain risks, which are slightly higher compared to vaginal delivery. These potential complications may include:
- Excessive blood loss (haemorrhage).
- Blood clot formation, which can dislodge and travel through the bloodstream (embolism).
- Injury to the bowel or bladder.
- Weakening of the uterine wall due to the incision.
- Placental abnormalities in future pregnancies.
- Risks associated with general anaesthesia.
- Possibility of foetal injury.
Additionally, there are some disadvantages to having a C-section, such as:
- More challenging recovery compared to vaginal delivery.
- Increased likelihood of experiencing chronic pelvic pain.
- Higher chances of having C-sections in future pregnancies.
- Potential difficulties with breastfeeding for the baby.
- Elevated risk of respiratory issues for the baby.
References
- Cleveland Clinic. C-section. Available from: https://my.clevelandclinic.org/health/treatments/7246-cesarean-birth-c-section
- Mayo clinic. C-section. Available from: https://www.mayoclinic.org/tests-procedures/c-section/about/pac-20393655
- Caesarean section. Available from: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cesarean-section
