How is a caesarean section performed? Planned caesarean section

In what cases is it assignedcaesarean sectionhow it is done and how it differs operational delivery from ordinary?

C-section- This alternative method delivery, which is used if, for some reason, childbirth through the natural birth canal is impossible. During this surgical operation, the child is removed through an incision in the anterior abdominal wall and uterus.

Caesarean section: indications for surgery

may be required in various cases. Allocate indications from the fetus and from the mother, relative and absolute, as well as indications for the operation in a planned or in urgent order.

Absolute indications for caesarean section- these are circumstances in which childbirth through the natural birth canal is impossible and the only way for the future baby to be born is surgery. These indications include:

full presentation placenta, when it completely or partially covers the internal uterine os, i.e. the exit from the uterus is closed for the fetus;
premature detachment a normally located placenta and severe bleeding with a low placenta, since both of these conditions pose a threat to the life of both the expectant mother and the baby;
anatomically narrow pelvis With to a large extent narrowing, deformation of the pelvic bones, that is, such changes that make it impossible for the fetus to pass through the birth canal;
wrong positions fetus: transverse position; foot presentation, when the baby is turned legs down; extensor positions when internal pharynx not the back of the head is turned, as it should be in the norm, but the forehead or face of the fetus;
failure of the scar on the uterus after the previous caesarean section, as there is a risk of uterine rupture along the postoperative scar, as well as two postoperative scars on the uterus;
uterine fibroids - large sizes or multiple, due to which, during labor pains, the uterus will not be able to fully contract;
severe forms preeclampsia - a complication of the second half of pregnancy, which is based on blood circulation disorders in small blood vessels maternal and fetal organisms. In this case, acute fetal hypoxia, placental abruption and disruption of vital functions may develop. important organs pregnant woman;
organ diseases of cardio-vascular system, kidneys, eyes, nervous system: these indications are determined by specialist doctors during pregnancy;
hypoxia - oxygen starvation fetus - if it is impossible to quickly deliver through the natural birth canal. If for some reason the fetus, while in the womb, begins to experience hypoxia, and the birth canal is not ready enough for delivery through the natural birth canal, surgery is performed in the interests of the fetus;
deformations, narrowing and postoperative changes cervix and vagina, in which childbirth through the natural birth canal is impossible;
exacerbation of genital herpes a month before childbirth, as this is fraught with infection of the child herpetic infection during passage through the birth canal;
prolapse or presentation of umbilical cord loops;
weakness labor activity in the absence of the effect of the therapy;
discrepancy between the size of the fetus and the size of the mother's pelvis during childbirth - the so-called clinical discrepancy, when the mother's head cannot be inserted into the birth canal due to its large size.

relative indications for caesarean section- these are situations in which delivery through the natural birth canal is possible, but may be associated with increased risk for both fetus and mother.

TO relative readings First of all, there are all obstetric situations in which acute hypoxia can occur - oxygen starvation of the fetus - and the need to quickly remove the child:

Preeclampsia of mild and medium degree. During birth process the phenomena of preeclampsia may become more severe, resulting in the development of fetal hypoxia.
Hemolytic disease of the newborn, which may develop as a result of Rhesus conflict. When the expectant mother has a negative Rh factor, and the future baby has a positive one, special substances can be released in the mother's body that destroy the baby's blood cells. This condition is called hemolytic disease. With its intrauterine development, the earliest possible birth of the fetus is necessary, and if there is no possibility of quick delivery through the natural birth canal, namely a well-prepared cervix, childbirth is carried out by caesarean section.
Scar on the uterus. Independent childbirth in this case, they are possible, but at any time signs of threatening uterine rupture along the postoperative scar may develop: in this case, C-section.
Pregnancy that occurred under the IVF program or with the help of other auxiliary reproductive technologies, as well as previously transferred severe gynecological diseases future mother. If pregnancy occurred with the help of assisted reproductive technologies, in particular IVF, this means that the woman had gynecological diseases, due to which spontaneous pregnancy was impossible. It could be different hormonal disorders, inflammatory diseases pelvic organs, endometriosis, etc.

These diseases can result in various complications during childbirth, for example, weakness of labor activity. In addition, women with a burdened obstetric and gynecological history (this is what the complex of previously transferred “female” diseases is called) more often develop preeclampsia, chronic hypoxia fetus. In such cases, a caesarean section can be performed according to the combination of indications.

The desire of the expectant mother is not an indication for caesarean section: this is cavity surgery associated with a certain risk and possible complications both during surgery and in the postoperative period. In addition, after a caesarean section, a scar remains on the uterus, the presence of which can lead to the development of complications during subsequent pregnancy and childbirth.

C-section can be performed both in a planned manner, when the operation is planned in advance, and in an emergency. Sometimes complications can develop during pregnancy or during childbirth, as a result of which the life of the unborn baby and the pregnant woman is in danger. Then a decision is made on operative delivery on an emergency basis. Indications for an emergency caesarean section are:

acute fetal hypoxia, when the baby abruptly begins to experience a lack of oxygen;
premature detachment of the placenta;
prolapse of umbilical cord loops;
weakness of labor activity, not amenable to drug therapy;
severe preeclampsia - a complication of the second half of pregnancy, in which acute fetal hypoxia, placental abruption and disruption of the vital organs of a pregnant woman can develop;
severe course Rh conflict;
signs of failure of the scar on the uterus after a previous caesarean section or other operation on the uterus.

Preparing for a caesarean

the day before planned operation the expectant mother goes to the chosen maternity hospital. To do this, the following tests must be submitted in advance:

general blood analysis;
general urine analysis;
biochemical analysis blood;
blood coagulation test - coagulogram;
testing for HIV, hepatitis B and C;
Wasserman reaction;
analysis for blood type and Rh factor.

the day before caesarean section a pregnant woman is talking to an anesthesiologist for a choice best method anesthesia and discussion of all the nuances of anesthesia for the upcoming operation. Epidural anesthesia can be chosen - a method of pain relief in which an anesthetic drug is injected into the epidural space located between the shell spinal cord And bone body lumbar vertebrae. As a result, complete anesthesia of the lower half of the body occurs, but the patient remains conscious. This is the most common type of anesthesia during caesarean section, because during the operation the woman remains conscious and can see her child and hear his cry. During epidural anesthesia, no negative influence on the fetus, as well as unpleasant phenomena that may occur after general anesthesia.

In addition, a woman may be offered general anesthesia. With this anesthesia, the anesthetic is delivered through a special mask. As a rule, this method of pain relief is used when there are contraindications to epidural anesthesia - for example, spinal injuries in the past, special forms curvature of the spine, and also if C-section needs to be done on an emergency basis and there is no time to prepare for an epidural. Such situations arise with premature detachment of a normally located placenta, prolapse of the umbilical cord - that is, in situations where the fetus experiences acute oxygen starvation and the only way to save it is an immediate operation.

To assess the condition of the baby, fetal cardiotocography (CTG) and ultrasound are performed.

the day before caesarean section food should be light, and after 19:00 it is not recommended to drink or eat. Otherwise, if there is a need for incubation ("mask") anesthesia, it will be necessary to carry out the procedure of gastric lavage so that its contents do not enter the respiratory tract.

Before bedtime expectant mother give a mild sedative to reduce nervous tension and excitement. 2 hours before the event surgical intervention a pregnant woman is given a cleansing enema.

How is a caesarean

From a surgical point of view C-section is a technically simple operation. Before it starts in urethra a urinary catheter is inserted so that during the operation bladder was emptied. After anesthesia, a transverse skin incision is made in the lower abdomen approximately 2–3 cm above the upper edge of the pubic bone. Then, the anterior wall of the abdomen is opened in layers, the uterine wall is carefully incised, and the baby is carefully removed from its cavity. Clamps are applied to the umbilical cord and crossed.

Just now born child handed over to the midwife, and she carries out the first toilet of the baby, measures height and weight. If anesthesia is performed by epidural anesthesia, the woman is conscious and can hear the first cry of her child and see him. Then the baby is taken to the neonatal unit, where he stays until the moment when his mother recovers from the operation and can take care of him herself. This can happen two days after caesarean section and until then the baby will be regularly brought in for feedings by nurses.

After removing the fetus from the uterine cavity, the placenta and fetal membranes are isolated and the uterine wall is carefully sutured. Then, the incision of the anterior abdominal wall is sutured in layers, a cosmetic suture is applied to the skin, neat and subsequently almost imperceptible. Within 12 hours after the operation, the puerperal is in the intensive care unit under the supervision of an anesthesiologist, after which, in the absence of complications, the patient is transferred to the postpartum ward.

After caesarean section

During the first few days after cesarean women are treated with antibiotics to prevent infectious complications, introduce drugs to reduce the uterus, as well as painkillers.

After caesarean section, as after any other abdominal surgery, there is a decrease in intestinal motility, therefore, on the first day postoperative period you can’t eat: this can lead to intestinal paresis, that is, bloating, because as a result of a decrease in peristalsis, food cannot fully move through the intestinal loops, as a result of which the intestine is stretched. Due to the stretched loops of the intestine, the abdomen swells, the anterior abdominal wall stretched. This can lead to impaired healing postoperative sutures and even to their divergence. Also, due to the fact that the intestinal wall is stretched and thinned, normal processes suction nutrients and trace elements, which can lead to depletion of the body. Therefore, on the first day after caesarean section you can only drink water; in addition to the above drugs, the puerpera is given solutions of glucose and vitamins to maintain energy resources organism. From the second day, you can start taking sparing food, and after 3-4 days you can return to the usual diet, taking into account the nutritional characteristics of a nursing mother.

Concerning motor activity in the postoperative period, it is currently believed that than used to be a woman begins to move in bed, roll over, sit down, get up and walk, the faster the recovery and the lower the risk of intestinal paresis. So, 12 hours after caesarean section you can try to carefully sit up in bed, and the next day after the operation - try to get up and walk. In addition, the sooner a woman begins to actively move, the sooner she can pick up her baby from the neonatal unit and be with him.

Usually after surgery caesarean section a woman can take care of her child already on the third day, and from that time on, mother and baby are together. And during the first or second day of the postoperative period, the children's nurse brings the child for feeding or the mother herself can go to children's department, feed your baby and chat with him.

There is a common myth that after caesarean section breastfeeding is impossible or very difficult. Actually it is not. Even though the baby and mother are not together for the first 1-2 days, it is possible to establish breastfeeding. After all, on the first day, the baby mostly sleeps and still does not need a lot of milk - a small amount of colostrum is enough for him, which a woman can give him when the baby is brought for feeding. And by the time the newborn needs a lot of milk and prolonged sucking, mother and baby are already together.

First time after surgery caesarean section while it is still hard for a young mother to sit for a long time, she feeds her baby lying down. Then the baby can be fed in any comfortable position. Many are concerned about the question: is it possible to pick up and carry a baby in the postoperative period, because it is known that after the operation one cannot lift “weights”? It is possible and necessary to take a child in your arms, but for the first 1-2 weeks you should try not to walk for a long time and not to stand with the baby in your arms, as this can increase tension in the abdominal muscles and cause additional discomfort. In the sitting position, the child can be kept without a time limit.

After childbirth, removable sutures are treated with an antiseptic solution or iodine. The sutures are removed on the 5-6th day after the operation.

Typically, an extract from postpartum ward after a caesarean section, it is performed on the 5-7th day, depending on the rules of the maternity hospital. On the eve of discharge, a woman is given ultrasonography to make sure the uterus is contracting well. In addition, young mothers take a general blood test and a general urine test.

Possible complications after cesarean

The most common complications after caesarean section are inflammation of the uterus and a violation of its contractility.

Inflammation of the uterus (endometritis) after caesarean section may develop as a result of direct contact during surgery with air, which may contain various infectious agents. In addition, the infection can travel up to the uterus from the vagina through the cervix. Signs of postoperative endometritis are an increase in body temperature, worsening general well-being, pain in the lower abdomen, as well as changes in general analysis blood - an increase in the number of white blood cells - leukocytes. Treatment is carried out intravenous administration solutions antibacterial drugs. Currently, such a complication after cesarean section is a rather rare occurrence, since in the postoperative period, all young mothers undergo antibiotic prophylaxis.

Abnormalities in uterine contraction (subinvolution) may occur after a caesarean section because an incision in the anterior wall causes the uterus to contract worse than after normal childbirth. For the prevention of subinvolution of the uterus in the postoperative period, special reducing substances are introduced. If the uterus nevertheless began to contract worse, this condition requires additional introduction these drugs.

Recovery after caesarean section usually takes about 2 months. To get in shape faster and reduce possible discomfort, you can wear a special postoperative bandage; the usual postpartum bandage is also suitable. If a woman is scheduled to have a caesarean section, she can take the bandage with her to the hospital. In general, after such an operation, you can lead a normal life, fully devote yourself to caring for the baby, do the usual homework. The only thing you should limit yourself to after a cesarean section is in the classroom active species sports in the first 6–8 months, since it is during this period that the complete healing of the postoperative scar on the uterus occurs.

So, the caesarean section is a method of delivery that helps to avoid many complications in unsuccessful childbirth or an unfavorable course of pregnancy. In modern obstetrics, the caesarean section technique has been brought to almost perfection, while the risk of complications is minimal. In addition, after this operation, you can fully care for the baby, establish breastfeeding and live a full life.

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Terms, duration and course of the operation

All pregnant women experience fear of childbirth. And even worse, if the birth will not take place naturally but by caesarean section. But to make it not so scary, let's figure out why a caesarean section is done, how long the operation is usually performed, how long it takes and consider the entire course of the operation.

During pregnancy monitoring, the doctor makes a recommendation on how the birth should go. If a woman's pregnancy is proceeding normally, then most likely, childbirth will take place naturally. If there are any abnormalities during the course of pregnancy or during the birth itself, then doctors may decide to carry out the birth using a caesarean section.

Distinguish between emergency and planned caesarean section:

given during pregnancy. In this case, the woman in labor prepares for the operation in advance, goes through all necessary examinations and at a predetermined period of pregnancy lies in the department of pathology. The most common indications for a planned caesarean section are:

premature detachment of the placenta;
hemolytic disease fetus;
multiple pregnancy;
severe form of preeclampsia;
absolutely narrow pelvis;
transverse position of the fetus, etc.

emergency caesarean section performed with unforeseen complications directly during childbirth, health threatening mother or child. The health of both the child and the mother may depend on the timeliness of the decision to perform the operation. In such situations, the qualifications of the doctor and the determination of the woman in labor are very important (after all, the operation cannot be performed without her consent).

Optimal timing

A planned caesarean section is usually done at 40 weeks pregnant. This optimal time for the operation - with a sufficient mass, the fetus is already considered full-term, and the child's lungs are sufficiently developed so that he can breathe on his own.

With a second cesarean section, the timing of the operation is shifted down - it is done a couple of weeks earlier than the planned delivery date, usually this is the 38th week of pregnancy.

This approach avoids the onset of contractions, which reduces the risk various complications during the operation. Remember that only a doctor can correctly determine how long to do a caesarean section in each case.

Preparing for the operation

A woman in labor who is scheduled for a planned caesarean is usually referred to the hospital about a week before the operation. If a woman wants to stay at home, then she can come to the hospital on the day when the operation will take place. But this is possible only if there is no severe complications and at good health mother and child.

Postoperative period

After the operation, painkillers are usually prescribed, as a woman experiences severe pain after a caesarean section. Also, depending on the condition of the woman, the doctor may prescribe various medications such as antibiotics, or supplements that improve performance gastrointestinal tract.

You can get up after the operation no earlier than six hours later. It is also recommended to buy a postoperative bandage, which will greatly facilitate the condition when walking.

Nutrition after the operation should be special - on the first day after a cesarean section, you can drink only plain water.

On the second day, a woman can try soups, cereals and other liquid foods.

On the third day, with proper recovery, you can eat any food that is allowed during lactation.

If you are still scheduled for a planned caesarean section, then do not be afraid. Most often, the fear of a caesarean is due to a lack of awareness about the progress of the operation. Knowing what exactly she has to go through, it is much easier for a woman to psychologically prepare herself for the upcoming events.

A caesarean section is an operation in which a viable baby is removed and children's place from a woman through an incision in the abdomen. On this moment this operation is not new and is well spread: every 7 woman goes into childbirth by caesarean section. Surgical intervention can be prescribed in a planned manner (according to indications during pregnancy) and in an emergency (in case of complications in natural childbirth).

What is a caesarean section

Birth by caesarean - obstetric surgery, which refers to emergency care. Every obstetrician-gynecologist should know the technique of execution. This is, first of all, salvation, in case of complicated pregnancy and childbirth, which helps to save the life of mother and child. In the process, it is not always possible to preserve the health of the child, especially with fetal hypoxia, infectious diseases, deep degree of prematurity or delayed pregnancy. Caesarean section is performed only for serious indications - the decision is made by the surgeon maternity ward.

Even with new technologies, high quality suture material, the procedure can cause complications such as:

bleeding;
embolism with amniotic fluid;
development of peritonitis;
thromboembolism pulmonary arteries;
divergence of postoperative sutures.

Why is it called

The word "caesar" is a form of the Latin word "caesar" (i.e. ruler). There are suggestions that the name refers to Gaius Julius Caesar. According to an old legend, the emperor's mother died during childbirth. The doctors of that era had no choice but to cut the belly of a pregnant woman in order to save the child. The operation was successful and the baby was born healthy. Since then, according to legend, this operation has been nicknamed.

According to another theory, the name may be associated with a law (published in the time of Caesar) which read: at the death of a woman in labor, save the child by dissecting the anterior abdominal wall and layers of the uterus, removing the fetus. For the first time, the operation to give birth to a baby, with a happy ending for mother and child, was performed by Jacob Nufer to his wife. All his life he performed operations - castration of boars. With a long and unsuccessful birth of his wife, he asked permission to make an incision in her with his own hand. The birth by caesarean was successful - mother and child survived.

Indications

The main indications for the procedure are as follows:

complete and incomplete placenta previa;
premature, rapid placental abruption with intrauterine fetal suffering;
failed scar on the uterus after previous births or other operations on the uterus;
the presence of two or more scars after caesarean;
anatomically narrow pelvis, neoplastic diseases or severe deformities of the pelvic bones;
postoperative conditions on pelvic bones and joints;
malformations of the female genital organs;
the presence of tumors in the pelvic cavity or in the vagina that block the birth canal;
the presence of uterine fibroids;
the presence of severe preeclampsia, and the lack of effect from treatment;
serious illnesses heart and blood vessels, diseases of the central nervous system, myopia and other extragenital pathology;
conditions after fistula suturing genitourinary system;
the presence of a perineal scar of the 3rd degree, after previous births;
varicose veins vaginal veins;
transverse arrangement of the fetus;
multiple pregnancy;
pelvic presentation of the fetus;
large fruit(more than 4000 g);
chronic hypoxia in the fetus;
age of primiparous over 30 years old, with diseases internal organs, which can aggravate childbirth;
prolonged infertility;
hemolytic disease in the fetus;
post-term pregnancy with unprepared birth canal, lack of labor activity;
cervical cancer;
the presence of the herpes virus with exacerbation.

Indications for emergency caesarean section

In some cases, surgery is necessary on an emergency basis. The indications will be:

severe bleeding;
clinically narrow pelvis;
amniotic fluid poured out prematurely, but there is no labor activity;
anomalies of labor activity that are not amenable to the action of medicines;
placental abruption and bleeding;
situation rupture-threatening uterus;
prolapse of umbilical cord loops;
incorrect insertion of the fetal head;
sudden death women in labor, and the fetus is alive.

The choice of a woman

In some clinics and states, they practice the operation at will. With help caesarean woman in labor wants to avoid pain, muscle gain pelvic floor in size, avoid vaginal incisions. Avoiding some discomfort, women in labor are faced with others, which in most cases need to be much more afraid - a violation of the baby's nervous system, difficulty in lactation, divergence of postoperative sutures, the inability to give birth naturally in the future, etc. Before planning the operation yourself, weigh the pros and cons.

Caesarean section: pros and cons

Many women in labor see obvious positive sides operations, but do not weigh the pros and cons of a caesarean section. From the pros:

removal of the baby without pain and in a short period;
confidence in the health of the fetus;
no damage to the genitals;
you can choose the date of birth of the baby.

Moms are not even aware of the disadvantages of such a procedure:

pain after the operation is very intense;
there is a possibility of complications after surgery;
possible problems with breastfeeding;
it is difficult to care for the baby, the risk of seam divergence;
long recovery period;
possible difficulties in subsequent pregnancies.

Kinds

Cesarean is: abdominal, abdominal, retroperitoneal and vaginal. Laparotomy is performed to extract a viable baby, for a non-viable baby, vaginal and abdominal wall surgery is possible. Types of cesarean section differ in the localization of the uterine incision:

Corporal caesarean - vertical section body of the uterus in the midline.
Isthmicocorporal - the incision of the uterus is located along the midline, partly in the lower segment and partly in the body of the uterus.
A cesarean section incision in the lower segment of the uterus, transverse with detachment of the bladder.
In the lower segment of the uterus, a transverse incision without detachment of the bladder.

How is it happening

The procedure for or how a caesarean is done for planned hospitalization is described below:

Before the operation, anesthesia is performed (spinal, epidural or general anesthesia), the bladder is catheterized, the abdominal area is treated with a disinfectant. There is a screen on the woman's chest to block access to the examination of the operation.
After the onset of anesthesia, the procedure begins. Initially, an abdominal incision is made: longitudinal - goes vertically from the pubic joint to the navel; or transverse - above the pubic joint.
After that, the obstetrician pushes abdominal muscles, cuts the uterus and performs an autopsy amniotic sac. After the newborn is removed, the placenta is delivered.
Next, the doctor sews up the layers of the uterus with special absorbable threads, then the abdominal wall is also sutured.
Impose a sterile bandage on the abdomen, an ice pack (for intensive contraction of the uterus, reducing blood loss).

How long does a caesarean section take

Normally, the operation lasts no more than 40 minutes, while the fetus is removed approximately at the tenth minute of the process. A large number of time takes layer-by-layer suturing of the uterus, peritoneum, especially when applying cosmetic suture so that the scar is not visible in the future. If complications arise during the operation (long-term anesthesia, acute blood loss in the mother, etc.), the duration may increase up to 3 hours.

Anesthesia methods

Methods of anesthesia are chosen depending on the condition of the woman in labor, the fetus, planned or emergency operation. Means that are used for anesthesia must be safe for the fetus and mother. It is advisable to carry out conduction anesthesia- epidural or spinal. Rarely resort to the use of general endotrachial anesthesia. In general anesthesia, a preliminary anesthesia is first introduced, after which a mixture of oxygen and a drug that relaxes the muscles is used, with anesthetic gas.

During epidural anesthesia, nerve roots spinal cord through a thin tube injected substance. A woman feels pain only during the puncture (a few seconds), then the pain in the lower body disappears, after which the condition is relieved. Throughout the procedure, she is conscious, fully present during the birth of the child, but does not suffer from pain.

Care after caesarean section

The entire period of the woman's stay in the maternity hospital, the processing of sutures is carried out by the medical staff. To replenish the fluid in the body for the first day, you need to drink plenty of water without gas. There is an opinion that a full bladder prevents the muscles of the uterus from contracting, so you need to go to the toilet often, without retaining fluid in the body for a long time.

On the second day it is already allowed to take liquid food, and from the third day (with normal flow postoperative period) you can resume the normal diet, which is allowed for lactating. Because of possible constipation do not recommend eating solid foods. This problem can be easily dealt with with enemas or glycerin suppositories. Should be consumed more fermented milk products and dried fruits.

In the first months, it is not recommended to visit pools or open water, take baths, you can only wash in the shower. It is recommended to start active physical activity not earlier than two months after the operation to restore the form. Start being active sexual life, follows only two months after caesarean. In case of any deterioration in the condition, it is necessary to consult a doctor.

Contraindications

When performing a caesarean section, contraindications should be taken into account. At the same time, if the procedure is prescribed for vital indications for a woman, they are not taken into account:

Fetal death in utero or developmental anomalies that are incompatible with life.
Fetal hypoxia, no urgent indications to cesarean on the part of a pregnant woman, with confidence in the birth of a viable baby.

Consequences

With surgery, there is a risk of such complications:

may appear pain near the seam;
long recovery organism;
possible infection of the scar;
the presence of a scar on the abdomen for life;
limitation physical activity long time;
impossibility of normal hygiene procedures for body;
limitation intimate relationships;
the likelihood of psychological shock.

What is dangerous for a child

Unfortunately, the surgical process does not pass without a trace for the child. Possible Negative consequences for baby:

Psychological. There is an opinion that in children there is a decrease in the reactions of adaptation to environment.
It is possible that there is amniotic fluid in the lungs of the baby, which remained after the operation;
Anesthesia drugs enter the baby's blood.

When can I have a baby after a caesarean section?

It is recommended to plan the next pregnancy after 5 years. This time is enough for complete scarring and restoration of the uterus. To prevent pregnancy from occurring before this period, it is recommended to use various methods contraception. Abortions are not recommended, since any mechanical intervention can provoke the development of inflammatory processes in the uterine wall or even its rupture.

Video

For many decades, this operation - caesarean section - allows you to save the life and health of the mother and her baby. In the old days, this was done surgical intervention extremely rarely and only if something threatened the life of the mother in order to save the child. However, caesarean section is now being used more and more frequently. Therefore, many specialists have already set themselves the task of reducing the percentage of births carried out by surgical intervention.

Who should perform the operation?

First of all, you should figure out how a caesarean section is done and what consequences await a young mother. By themselves, childbirth by the surgical method is quite safe. However, in some cases, operations are simply inappropriate. After all, no one is immune from risk. Many expectant mothers ask for a caesarean section only because of fear of severe pain. modern medicine offers in this case epidural anesthesia, which allows a woman to give birth without pain.

Such births are performed - caesarean section - by a whole team medical workers, which includes specialists of a narrow profile:

Obstetrician-gynecologist - directly extracts the baby from the uterus.
Surgeon - performs an incision in soft tissues and muscles abdominal cavity to reach the uterus.
A pediatric neonatologist is a doctor who takes in and examines a newborn baby. If necessary, a specialist in this profile can provide the child with first aid, as well as prescribe treatment.
Anesthesiologist - performs anesthesia.
Nurse anesthetist - helps to administer anesthesia.
Operating nurse - assists doctors if necessary.

The anesthetist should talk to the pregnant woman before the operation to determine which type of pain relief is best for her.

Types of caesarean section

Indications for caesarean section can be completely different, and the operation is performed in certain cases in different ways. To date, there are two types of childbirth carried out with the help of surgical intervention:

Emergency surgery is performed if any complication occurs during childbirth that requires urgent removal of the baby from the uterus. A planned caesarean section is performed in situations where the doctor is concerned about the progress of childbirth due to complications that arose during pregnancy. Let's take a closer look at the differences between the two types of operations.

Planned caesarean section

A planned operation (caesarean section) is performed with epidural anesthesia. Thanks to this method, a young mother has the opportunity to see her newborn baby immediately after the operation. When carrying out such a surgical intervention, the doctor makes a transverse incision. The child usually does not experience hypoxia.

emergency caesarean section

For an emergency caesarean section, general anesthesia is usually used during the operation, since the woman may still have contractions, and they will not allow an epidural puncture. The incision in this operation is mainly longitudinal. This allows you to remove the baby from the uterine cavity much faster.

It is worth noting that during an emergency operation, the child may already experience severe hypoxia. At the end of the cesarean section, the mother cannot immediately see her baby, as they do a cesarean section in this case, as already mentioned, most often under general anesthesia.

Types of incisions for caesarean section

In 90% of cases, a transverse incision is made during the operation. As for the longitudinal one, they are currently trying to do it less often, since the walls of the uterus are greatly weakened. In subsequent pregnancies, they can simply overstrain. A transverse incision made in the lower part of the uterus heals much faster, and the sutures do not break.

A longitudinal incision is made along the midline of the abdominal cavity from the bottom up. To be more precise, to a level just below the navel from the pubic bone. Making such an incision is much easier and faster. Therefore, it is he who is usually used for emergency cesarean section in order to extract the newborn baby as quickly as possible. The scar from such an incision is much more noticeable. If doctors have the time and opportunity, then during the operation a transverse incision can be made slightly above the pubic bone. It is almost invisible and heals beautifully.

Concerning reoperation, then the seam from the previous one is simply excised.
As a result, only one seam remains visible on the woman's body.

How is the operation going?

If the anesthesiologist performs epidural anesthesia, then the site of the operation (incision) is hidden from the woman by a partition. But let's see how a caesarean section is done. The surgeon makes an incision in the wall of the uterus, and then opens the fetal bladder. Then the child is removed. Almost immediately, the newborn begins to cry a lot. Children's doctor cuts the umbilical cord, and then carries out all the necessary procedures with the child.

If the young mother is conscious, then the doctor shows her the baby right away and can even let her hold it. After that, the child is taken to a separate room for further observation. The shortest period of the operation is the incision and removal of the child. It takes only 10 minutes. These are the main advantages of a caesarean section.

After that, doctors must remove the placenta, while treating all the necessary vessels with high quality so that bleeding does not start. The surgeon then sews up the cut tissue. A woman is put on a drip, giving a solution of oxytocin, which accelerates the process of uterine contraction. This phase of the operation is the longest. From the moment the baby is born to the end of the operation, it takes about 30 minutes. In time, this operation, a caesarean section, takes about 40 minutes.

What happens after childbirth?

After the operation, the newly-made mother is transferred from the operating unit to the intensive care unit or to the ward intensive care, as they do a caesarean section quickly and with anesthesia. The mother should be under the vigilant supervision of doctors. At the same time, it is constantly measured arterial pressure, respiratory rate, pulse. The doctor must also monitor the rate at which the uterus is contracting, how much discharge and what character they have. IN without fail the functioning of the urinary system should be monitored.

After a caesarean section, the mother is given antibiotics to avoid inflammatory process, as well as painkillers to relieve discomfort.

Of course, the disadvantages of a caesarean section may seem significant to some. However, in some situations, it is precisely such childbirth that allows a healthy and strong baby to be born. It is worth noting that a young mother will be able to get up only after six hours, and walk on the second day.

Consequences of surgery

After the operation, stitches remain on the uterus and abdomen. In some situations, diastasis and suture failure may occur. If such effects occur, you should immediately consult a doctor. Complex treatment the divergence of the edges of the seam located between the rectus muscles includes a set of exercises specially developed by many specialists that can be performed after a cesarean section.

The consequences of this surgical intervention, of course, are available. The very first thing to highlight is an ugly seam. You can fix it by visiting a beautician or a surgeon. Usually to give the seam an aesthetic appearance perform procedures such as smoothing, grinding and excision. Enough a rare occurrence keloid scars are considered - reddish growths form above the seam. It should be noted that the treatment of this kind of scars lasts a very long time and has its own characteristics. It must be carried out by a professional.

Much more for a woman more important condition the suture that is made on the uterus. After all, it depends on him how it goes next pregnancy and how the woman will give birth. The suture on the abdomen can be corrected, but the suture on the uterus cannot be corrected.

Menstruation and sexual life

If there were no complications during the operation, then menstrual cycle begins and passes in the same way as after natural childbirth. If a complication nevertheless arose, then the inflammatory can proceed for several months. In some cases, menstruation can be painful and heavy.

You can start having sex after childbirth with a scalpel after 8 weeks. Of course, if the surgical intervention went without complications. If there were complications, then you can start having sex only after thorough examination and medical advice.

It should be borne in mind that after a cesarean section, a woman should use the most reliable contraceptives, since she cannot become pregnant for about two years. It is undesirable to carry out operations on the uterus for two years, as well as abortions, including vacuum ones, since such an intervention makes the walls of the organ weaker. As a result, there is a risk of rupture during a subsequent pregnancy.

lactation after surgery

Many young mothers who have undergone surgery worry that it is difficult to establish feeding after a caesarean. breast milk. But this is absolutely not true.

Milk from a young mother appears at the same time as women after natural childbirth. Of course, breastfeeding after surgery is a little more difficult. This is primarily due to the characteristics of such genera.

Many doctors fear that the baby may get part of the antibiotic in the mother's milk. Therefore, in the first week, the baby is fed with a formula from a bottle. As a result, the baby gets used to it and it becomes much more difficult to accustom him to the breast. Although today babies are often applied to the breast immediately after surgery (on the same day).

If you do not have indications for delivery by caesarean section, then you should not insist on an operation. After all, any surgical intervention has its consequences, and it is not for nothing that nature has come up with a different way for the birth of a child.

A caesarean section is a method of removing the baby and placenta from the uterus through incisions in the anterior wall of the abdomen and the muscle itself. This is a fairly common procedure, which is considered almost the norm.

When is a caesarean section performed?

The decision to this species surgery is accepted only if there is no other solution to the problems that have arisen during childbirth. The prerequisites that determine the need for a cesarean are:

detachment of the placenta;
child's suffocation;
small uterine dilatation;
bad feeling child in childbirth;
genital tract infections;
narrow pelvis;
scars on the walls of the uterus;
pathology of the heart and blood vessels;
risk of detachment eye retina etc.

How long does a caesarean section take?

Minimum allowable time dissection is 38 weeks. More early term fraught with unforeseen complications for the baby. To reduce the risk of error in, the preferred date is the 39th or 40th week.

Do they do caesarean at will?

There is a right to choose the date of the planned operation, but only in the case of a satisfactory pregnancy. If a woman, for her own personal reasons, wants to have a cesarean, then she needs to write an application addressed to the head antenatal clinic or arrange with your obstetrician-gynecologist.

How is a caesarean section done?

Many are interested in preparing for the operation, whether they do an enema before a cesarean and how everything will actually happen. On the appointed day, you must refuse food and drink minimal amount liquids. You will definitely shave your pubis, put a catheter and a cleansing enema. Cesarean section is done under anesthesia, general or local spectrum of action. The latter is used at will and makes it possible to "participate" in childbirth. How long does a caesarean section take - the most popular question among mothers and their relatives. The process of removing the child occurs already at the 5th minute after dissection and stretches for a maximum of 7 minutes. The caesarean section itself lasts 20-40 minutes. Naturally, the very process of how a caesarean section is done is also of interest. During the operation, the surgeon makes a dissection of the abdominal cavity, uterus and fetal bladder. Pulls out the child and afterbirth. All incisions, in a certain order, are sutured with special absorbable threads. superimposed sterile dressing and a cold heating pad, necessary to increase the intensity of uterine contractions.

Does it hurt to do a caesarean?

The operation itself is completely painless for the mother, who is under anesthesia. But the period of "departure" from the anesthetic drug is marked severe pain, to overcome which antibiotics, analgesics and other medicines will help a wide range actions.

What injections are given after a caesarean?

After the operation, the woman is given injections of a drug that promotes contractile activity uterus, which must expel from itself blood clots and lochia. You also have to inject painkillers and medicines to improve the work of housing and communal services.

How is a second caesarean done?

It differs from the first one in the location of the incision, which will be either classical, or lower transverse, or located in the vertical lower part of the uterus.

How many times can you do a caesarean?

After a primary operation of this type, there is a possibility of self-re-delivery. In two or three caesarean woman sterilization is recommended to avoid unforeseen severe complications.

Where is a caesarean section done?

The decision about the place of the operation and the specialist who performs it is made by the mother herself, based on her preferences and beliefs. Any maternity hospital is fully prepared for both planned and emergency caesarean.