In what year did the caesarean section begin? C-section

HISTORY OF CAESAREAN SECTION

Caesarean section has been part of human culture since ancient times. According to Greek mythology, Apollo took out Asclepius, the founder of the famous cult religious medicine, from his mother's belly. A large number of links to C-section is in history ancient india, Egypt, Greece, Roman state, China.

Until now, the history of caesarean section remains shrouded in a shroud of myths and raises doubts about its accuracy. In ancient times, the procedure was performed only when the mother was dead or dying in order to save the child. Roman law under Caesar stated that all women who were doomed to death in childbirth should be "dissected", i.e. cesareans. It is believed that the origin of the term "caesarean" is associated with the birth of Julius Caesar in this way. However, another origin of the word is also considered. Possibly the verb "caedare," meaning incision, and the term "caesones," which was applied to newborns born through post-mortem operations.

Until the 16th and 17th century, the procedure was known as a caesarean operation. It began to develop following the publication in 1598 of Jacques Guillimeau of a book on obstetrics in which he introduced the term "section". Increasingly after that, the term "section" replaced the term "operation". For a long time, surgery was the measure that was addressed in last turn, and it was not intended to save the life of the mother, and only in the 19th century such an opportunity appeared. There are, however, isolated early reports of heroic efforts to save the mother's life as a result of the operation. It is possible that the very first information about mother and child surviving caesarean section came from Switzerland, where in 1500 pig castrator Jacob Nufer performed the operation on his wife. After several days of childbirth and the help of 13 midwives, the woman was unable to give birth to her child. Her desperate husband eventually got permission from the elders to attempt a caesarean section. The mother survived and subsequently gave birth normally to 5 more children, including twins. The caesarean baby lived up to 77 years.

Thanks to his work in animal husbandry, Nufer possessed, albeit minimally, but still knowledge of anatomy. The development of anatomy later served as a significant stimulus in the development of surgery and caesarean section as well. During the 16th and 17th centuries, a large number of works appeared, illustrating human anatomy in detail, in particular the female pelvis.

The caesarean section was performed not only in Europe. Travelers in Africa in the 19th century reported cases of local healers successfully operating on their own medical methods. In 1879, for example, an English traveler witnessed a caesarean section performed by a Ugandan. The healer used banana wine to semi-drunk the woman and disinfect his hands and her stomach before the operation. He used a median incision and applied cauterization to stop the bleeding, then massaged the uterus to make it contract, but did not stitch it up. The abdominal wound was fastened with metal needles and closed with a paste prepared from the roots. According to eyewitnesses, the patient recovered.

The development of caesarean section was directly related to the success of general surgery. In the early 1800s, when surgeons still relied on the old methods, they were feared and treated little better than barbers, butchers, or tooth pullers. Although most surgeons had anatomical knowledge, they were limited by the patient's pain and the problem of infection. Surgery continued to be a barbaric discipline, and the best surgeons were determined by the speed with which they could amputate a limb or sew up a wound. new era in surgical practice began in 1846 when dentist William T.G. Morton used ether to remove a tumor on his face. This method of anesthesia quickly spread throughout Europe. In obstetrics, the method also gained popularity especially after chloroform was used in childbirth with Queen Victoria at the birth of her two children (Leopold in 1853 and Beatrice in 1857).

Anesthetics have given surgeons time to perform the operation more accurately and have the opportunity to learn from experience. Women, on the other hand, were relieved of suffering during surgery and were less susceptible to shock, which was one of the leading causes of postoperative mortality and morbidity. Despite our successes, the mortality from the operation remained high, and the reason for this was infection. Prior to the acceptance of germ theory infectious diseases and the advent of modern bacteriology in the second half of the 19th century, surgeons operated in their street clothes. In the mid-1860s, the English surgeon Joseph Lister introduced an antiseptic method using carbolic acid. In the future, measures were developed to maintain cleanliness during surgical operations. At the end of the century, antiseptics and asepsis allowed to solve many problems of surgical infection.

The surgical technique of the time also contributed to high maternal mortality. So in Paris, according to one source, between 1787 and 1876, not a single woman survived after a caesarean section. Surgeons were afraid to sew up the incision on the uterus, as they believed that internal seams, which subsequently could not be removed, can become a source of infection and cause uterine rupture in subsequent pregnancies. They believed that the muscles of the uterus contracted, leading to the closure of the wound. However, this did not happen. As a result, some women died from blood loss, but most from infectious complications. After anesthesia, antisepsis and asepsis were finally established in surgery, obstetricians were able to focus on improving the technique of performing caesarean section. In 1876, the Italian professor Eduard Porro proposed, in parallel with the caesarean section, to remove the uterus, thereby preventing bleeding and the development of a generalized infection. This allowed to reduce the incidence of postoperative sepsis and mortality. However, this crippling technique was soon abandoned, as the technique of suturing the uterus was developed. In 1882, Max Saumlnger of Leipzig put uterine sutures into practice. To do this, he suggested using silver wire stitches. In the 20th century, the caesarean section underwent rapid development and today is the leading obstetric surgery allowing many problems to be solved. O state of the art cesarean section operations will be discussed in the next article.

Bibliography

A.Sh. Makhmutkhodzhev, E.V. Makhmutkhojaev. History of caesarean section

A caesarean section is a surgical procedure that removes the baby through an incision in the abdomen rather than through the vagina. AT recent times about 30% of births are by caesarean section. In some cases, this is done as planned due to pregnancy complications or because the woman has already had a caesarean section. Some women prefer a caesarean section to a conventional birth. However, in many cases, the need for a caesarean section becomes apparent only during childbirth.

Knowing what to expect will help you better prepare if surgery is needed.

A caesarean section is a surgical procedure to remove a baby from the mother's womb. In this case, he is not born naturally, but casts its first glance at the world through the incision that is made when opening the uterus. In Germany, every year, 20 to 30 percent of children are born by caesarean section.

Indications for caesarean section

Indications for caesarean section can be absolute and relative. But for the most part, the decision to have surgery stems from many factors at once, such as a combination of medical assessments by the doctor and midwife, and personal wishes on the part of the woman in labor. Fortunately, pregnant women have enough time to think things over and understand exactly how they would like to give birth. Emergencies, when a caesarean section becomes inevitable, are rare.

If you decide to have a caesarean section, you must confirm your consent to the operation in writing. But first, the doctor will give you the most detailed explanations. During this conversation, you should discuss in detail all possible risks to make you really feel well prepared. So don't hesitate to ask if you don't understand something.

Medical indications for a caesarean section include:

transverse or pelvic presentation of the child;
placenta previa;
maternal pelvis size mismatch
the size of the child;
severe illness of the mother;
the threat of hypoxia of the child;
premature birth;
developmental pathology of the child.

Partial anesthesia for caesarean section

Currently local anesthesia is the universally accepted standard. The operation is performed under spinal anesthesia or in a planned caesarean section with epidural-spinal anesthesia (see page 300). General anesthesia is recommended only in cases where other anesthesia is not possible for medical reasons.

When is a cesarean section done?

There are many reasons why a caesarean section is done. Sometimes this is due to the health of the mother, sometimes with fears for the child. Sometimes surgery is done even if both mother and child are fine. This is a cesarean by choice, and the attitude towards it is ambiguous.

The birth is not going well. One of the main reasons why a caesarean section is done is that labor does not go well - it stops too slowly or stops altogether. The reasons for this are manifold. The uterus may not contract forcefully enough to fully dilate the cervix.

The child's heart is broken. In most cases, the baby's heart rate allows you to expect a successful outcome of childbirth. But sometimes it becomes obvious that the child does not have enough oxygen. If there are such problems, the doctor may recommend a caesarean section.

Heart problems can occur if the baby is not getting enough oxygen, the umbilical cord is clamped, or the placenta is not functioning well. Sometimes violations heart rate occur, but nothing indicates a real danger to the child. In other cases it is obvious serious danger. One of the most difficult decisions for doctors is deciding how big this danger is. The doctor can try different methods, for example, massage the head, and see if the work of the heart improves.

The decision to have a caesarean depends on many factors, such as how long the birth will continue or how likely there are other complications besides heart failure.

The unfortunate position of the child. If the baby enters the birth canal with the legs or buttocks forward, this is called a breech presentation. Most of these babies are born by caesarean section, because conventional births are more likely to have complications. Sometimes the doctor is able to move the baby into the correct position by pushing it through the abdomen before labor begins, thereby avoiding surgery. If the baby lies horizontally, this is called a transverse presentation and is also an indication for a caesarean section.

The baby's head is in the wrong position. Ideally, the baby's chin should be pressed against the chest so that the part of the head that has the smallest diameter is in front. If the chin is raised or the head is turned so that the smallest diameter is not in front, the larger diameter of the head should pass through your pelvis. Some women do not have any problems in this case, but others may have difficulties.

Before having a caesarean, your doctor may ask you to get on all fours - in this position, the uterus drops forward and the baby may turn. Sometimes the doctor may be able to turn the glans during a vaginal examination or with forceps.

You serious problems with health. A caesarean section can be done if you have diabetes, diseased heart, lungs or high blood pressure. With such diseases, a situation may arise when it is preferable to give birth to a child for more early stage pregnancy. If induction of labor fails, a caesarean section may be necessary. If you have serious health problems, discuss your outlook with your doctor well in advance of your pregnancy.

Rarely, a caesarean section is done to prevent the baby from contracting a herpes infection. If a mother has herpes in her genitals, it can be passed on to a newborn baby and cause serious illness. Caesarean section avoids this complication.

You multiple pregnancy. Approximately half of twins are born by caesarean section. Twins can also be born in the usual way, depending on the weight, position and gestational age. Triplets and more are a different story. Most triplets are delivered by caesarean section.

Every multiple pregnancy is unique. If this is your case, discuss the prospects for childbirth with your doctor and decide together what is best for you. Remember that everything is changeable. Even if both babies are head first, the situation may change after the first is born.

There are problems with the placenta. In two cases, a caesarean is necessary: placental abruption and placenta previa.

Placental abruption occurs when the placenta separates from the wall of the uterus before labor begins. This can pose a threat to the life of both you and the child. If the electronic monitoring shows that there is no immediate danger to the baby, you will be admitted to the hospital and will be closely monitored. If the child is in danger, urgent delivery and a caesarean section will be used.

The placenta cannot be born first, because then the child will lose access to oxygen. Therefore, almost always a caesarean is done.

There are problems with the umbilical cord. When the water has broken, the cord can slip out of the cervix before the baby is born. This is called cord prolapse and represents great danger for a child. As the baby squeezes through the cervix, pressure on the umbilical cord can cut off oxygen. If the umbilical cord slips out when the cervix is fully dilated and labor has already begun, you can give birth normally. Otherwise, only a caesarean section can save the situation.

Also, if the umbilical cord is wrapped around the baby's neck or is between the head and pelvic bones if water is out, each contraction of the uterus will compress the umbilical cord, slowing down blood flow and reducing oxygen supply to the baby. In these cases, a caesarean section best option, especially if the umbilical cord is squeezed for a long time or very hard. it common cause heart problems, but it is usually impossible to know for sure where the umbilical cord is located before labor begins.

The child is very big. Sometimes the baby is too big to be successfully born in the normal way. The size of the baby can be a problem if you have an abnormally narrow pelvis that the head cannot pass through. Occasionally, this may be a consequence of a pelvic fracture or other deformities.

If you develop diabetes during pregnancy, your baby may gain very big weight. If the baby is too large, a caesarean section is preferable.

Child health problems. If a defect such as spina bifida is diagnosed in a child in the mother's womb, the doctor may recommend a caesarean section. Discuss the situation in detail with your doctor.

You've already had a cesarean. If you've had a caesarean before, you may need to do it again. But this is optional. Sometimes, after a caesarean section, a normal birth is possible.

How is a caesarean section

Before a planned caesarean section, the gynecologist or anesthesiologist will tell you in advance about the operation and methods of anesthesia. If you don't understand something, please clarify and ask again! On the appointed day, you must arrive at the hospital in advance. It is best to refrain from eating: you cannot eat for six hours before the operation.

First of all, the doctor and midwife will check your baby's condition with the help of ultrasound and CTG. Take this opportunity to express your wishes and ideas about upcoming birth. Then the preparation for the operation will begin: your hair will be shaved off in the incision area, you will be put on compression stockings and spinal anaesthesia. Later, already in the operating room, the surface of the abdomen will be disinfected and a catheter will be inserted into the bladder. Before the operation begins, your entire body, with the exception of the abdomen, will be covered with sterile wipes. To prevent you from seeing what is happening and to prevent infection, the nurses will pull the sheet up to the level of your upper abdomen. Although you will be able to see the heads of the members of the operating team, you will not be able to understand what they are doing with their hands. After the anesthesia begins to operate in full force, the doctor will make the first incision.

For cosmetic reasons and for better healing wounds, skin dissection is performed directly above the symphysis (pubic articulation) along a vertical line, the length of the incision is 10 cm. Subcutaneous adipose tissue splits in the middle. Above the abdominal muscles is a very elastic and strong connective tissue sheath (fascia), which the surgeon opens with a scalpel in the center. Then he pulls the abdominal wall up with his hand and takes the abdominal muscles to the side. To open the peritoneum, the doctor uses only his fingers. At the same time, he must make sure that he does not injure either the intestines or the bladder. Finally, the doctor makes a transverse incision in the lower segment of the uterus with a scalpel. Now it remains only to get the baby out of the uterus, and you can say hello to your baby. After separation and removal of the placenta, the operating team sews up the wound. Meanwhile, your partner is already accompanying the child for the first examination. In total, the operation lasts from 20 to 30 minutes.

Misgav Ladakh method

The so-called “soft” surgical technique described on the previous pages, developed in the Israeli hospital Misgav Ladakh, is used today, with small deviations in all maternity clinics.

Risks of a caesarean section

A caesarean section is a major operation. Although it is considered quite safe, as with any operation, there are certain risks. It is important to remember that a caesarean section is often done to avoid life-threatening complications. However, after the operation, certain complications can also occur.

Risks for you. Having a baby is always a risk. With caesarean section, it is higher than with conventional childbirth.

Increased bleeding. On average, blood loss during a caesarean section is twice as much as during a conventional birth. However, a blood transfusion is rarely required.
Reactions or anesthesia. Medicines used during surgery, including painkillers, can sometimes cause unintended effects, including breathing problems. AT rare cases general anesthesia can cause pneumonia if a woman inhales stomach contents. But general anesthesia is rarely used for caesarean sections, and care is taken to avoid such complications.
Injury to the bladder or intestines. Such surgical injuries are rare, but they do occur during caesarean section.
Endometritis. This is a complication that causes inflammation and infection of the membrane lining the uterus, most commonly after a caesarean section. This happens when bacteria normally found in the vagina enters the uterus. Urinary tract infection.
Slow down bowel activity. In some cases, the pain medications used during surgery can slow down the bowels, causing bloating and discomfort.
Blood clots in the legs, lungs and pelvic organs. The risk of a blood clot in the veins is 3-5 times higher after a caesarean section than after a conventional birth. If left untreated, a blood clot in the leg can travel to the heart or lungs, disrupt circulation, causing chest pain, shortness of breath, and even death. Blood clots can also form in the veins of the pelvis.
Wound infection. The possibility of such an infection after a caesarean section is higher if you drink alcohol, have type 2 diabetes, or are overweight.
Rupture of seams. If the wound is infected or does not heal well, there is a risk of rupture of the stitches.
Placenta accreta and hysterectomy. Placenta accreta is attached too deeply and too firmly to the wall of the uterus. If you have already had a caesarean section, next pregnancy the likelihood of placenta accreta increases significantly. Placenta accreta is the most common cause of hysterectomy for caesarean section.
Rehospitalization. Compared with women who have given birth vaginally, women who have had a caesarean section are twice as likely to be admitted to the hospital a second time within the first two months after giving birth.
Fatal outcome. Although the chance of death after a caesarean section is very low - about two per 100,000 - it is almost twice as high as after natural childbirth.

risk for the child. A caesarean section is potentially dangerous for the baby as well.

premature birth. If the caesarean is of your choice, the child's age must be determined correctly. Premature birth can lead to respiratory failure and low weight at birth.
Breathing problems. Babies born by caesarean section are more likely to have a slight breathing problem - they breathe abnormally frequently during the first days after birth.
Injury. Rarely, the child may be injured during surgery.

What to Expect During a Cesarean Section

Whether you have a caesarean section planned or done out of necessity, it will go something like this:

Training. To prepare you for the operation, some procedures will be done. In urgent cases, some steps are reduced or skipped altogether.

Anesthesia methods. An anesthesiologist may come to your room to discuss anesthesia options. Spinal, epidural and general anesthesia are used for caesarean section. With spinal and epidural anesthesia, the body loses sensation below the chest, but you remain conscious during the operation. At the same time, you practically do not feel pain, and the drug practically does not get to the child. There is little difference between spinal and epidural anesthesia. In a spinal anesthetic, an anesthetic is injected into the surrounding fluid. spinal nerves. With an epidural, the agent is injected outside the fluid-filled space. Epidural anesthesia is carried out within 20 minutes and lasts a very long time. Spinal is done faster, but only lasts about two hours.

General anesthesia, in which you are unconscious, can be used for an emergency caesarean section. Some of the drug may pass to the child, but this usually does not cause problems. Most children are not affected by general anesthesia, because the mother's brain absorbs the drug quickly and in large quantities. If necessary, the child will be given medication to relieve the effects general anesthesia.

Other preparations. Once you, your doctor, and anesthesiologist have decided which type of pain relief to use, preparations will begin. They usually include:

intravenous catheter. An intravenous needle will be placed in your arm. This will allow you to get the fluids and medicines you need during and after your surgery.
Blood analysis. Your blood will be drawn and sent to a laboratory for analysis. This will allow the doctor to assess your condition before surgery.
Antacid. You will be given an antacid to neutralize stomach acids. This simple measure greatly reduces the risk of lung damage if you vomit during anesthesia and the contents stomach hit into the lungs.
Monitors. During surgery, your blood pressure will be continuously monitored. You may also be connected to a heart monitor with sensors on your chest to monitor your heart and rhythm during surgery. A special monitor can be attached to the finger to monitor the level of oxygen in the blood.
urinary catheter. A thin tube will be inserted into the bladder to drain urine to keep the bladder empty during surgery.

Operating room. Most caesarean sections are done in operating rooms specifically designed for this purpose. The atmosphere may differ from the one that was in the family. Because operations are group work there will be more people here. If you or your child has serious medical problems, will be attended by physicians of various specialties.

Training. If you are going to have an epidural or spinal anesthetic, you will be asked to sit with your back rounded, or lie on your side, curled up. The anesthesiologist wipes the back antiseptic solution and give you an injection of painkillers. He will then insert the needle between the vertebrae through dense fabric surrounding the spinal cord.

You may be given one dose of pain medication through a needle and then removed. Or a thin catheter is inserted through the needle, the needle is removed, and the catheter is glued with a plaster. This will allow you to receive new doses of pain medication as needed.

If you require general anesthesia, all preparations for the operation will be made before you receive pain medication. The anesthesiologist will administer pain medication through an intravenous catheter. You will then be placed on your back with your legs fixed. A special pad may be placed under your back on the right so that your body leans to the left. This shifts the weight of the uterus to the left, which ensures its good blood supply.

Hands are pulled out and fixed on special pillows. The nurse will shave off the pubic hair if it might interfere with the operation.

The nurse will wipe the stomach with an antiseptic solution and cover it with sterile wipes. A tissue will be placed under the chin to keep the surgical field clean.

Incision abdominal wall. When everything is ready, the surgeon makes the first incision. This will be an incision in the abdominal wall, about 15 cm long, cutting through the skin, fat and muscle to get to the lining abdominal cavity. Bleeding vessels will be cauterized or ligated.

The location of the incision depends on several factors: whether your caesarean section is an emergency and whether you have other scarring on your abdomen. The size of the baby and the location of the placenta are also taken into account.

The most common types of incisions:

Low horizontal cut. Also called a bikini slit and runs in the lower abdomen along the line of an imaginary bikini panty, is preferred. Heals well and causes less pain after surgery. Also preferred for cosmetic reasons and allows the surgeon to clearly see the lower part of the pregnant uterus. b Low vertical cut. Sometimes this type of incision is preferred. It provides quick access to the lower part of the uterus and allows you to remove the baby faster. In some cases, time is the most important thing.
Incision of the uterus. After completing the incision in the abdominal wall, the surgeon pushes back the bladder and cuts the wall of the uterus. The uterine incision may be the same or different type as the abdominal wall incision. It is usually smaller in size. As with an abdominal incision, the location of the uterine incision depends on several factors, such as the urgency of the operation, the size of the baby, and the location of the baby and placenta within the uterus. A low horizontal incision at the bottom of the uterus is the most common, used in most caesarean sections. It provides easy access, bleeds less than higher incisions, and is less likely to damage the bladder. A strong scar is formed on it, which reduces the risk of rupture during subsequent births.
In some cases, a vertical incision is preferable. A low vertical incision - in the lower part of the uterus, where the tissues are thinner - can be done with the baby in the legs, buttocks, or across the uterus (breech or transverse presentation). It is also used if the surgeon believes it will have to be extended to a high vertical incision - sometimes referred to as the classic. The potential advantage of the classic incision is that it allows easier access to the uterus to remove the baby. Sometimes a classic incision is made to avoid trauma to the bladder or if the woman thinks this is her last pregnancy.

Birth. Once the uterus is open, the next step is to open amniotic sac so that the child can be born. If you are conscious, you may feel some twitching and pressure as the baby is pulled out. This is done in such a way as to keep the cut size as small as possible. You won't feel pain.

When the baby is born and the umbilical cord has been cut, the baby will be given to a doctor who will check that the nose and mouth are free of fluid and that he is breathing well. In a few minutes, you will see your baby for the first time.

After birth. Once the baby is born, the next step is to separate and remove the placenta from the uterus, and then close the incisions, layer by layer. The stitches on the internal organs and tissues will dissolve themselves and do not require removal. For a skin incision, the surgeon may suture or use special metal clips to hold the edges of the wound together. During these activities, you may feel some movement, but no pain. If the incision is closed with clamps, they will be removed with special tweezers before discharge.

When you see the child. The entire caesarean section usually takes 45 minutes to an hour. And the baby will be born in the first 5-10 minutes. If you are awake and willing, you can hold the baby while the surgeon closes the incisions. Or you may be able to see the baby in your partner's arms. Before giving the baby to you or your partner, doctors will clean his nose and mouth and perform the first assessment on the Apgar scale - this is a quick assessment of the child's appearance, pulse, reflexes, activity and breathing one minute after birth.

Postoperative ward. There, you will be monitored until the anesthesia wears off and your condition stabilizes. This usually takes 1-2 hours. During this time, you and your partner will be able to spend a few minutes alone with the child and get to know him.

If you choose to breastfeed your baby, you can do so for the first time in the recovery room if you feel like it. The sooner you start feeding, the better. However, after general anesthesia, you may not feel well for several hours. You may want to wait until you are completely awake and receive pain medication before feeding.

After caesarean section

In a few hours, you will be transferred from the recovery room to the delivery room. Over the next 24 hours, doctors will monitor your well-being, the condition of the stitches, the amount of urine produced and postpartum hemorrhage. Throughout your stay in the hospital, your condition will be closely monitored.

Recovery. Usually, after a caesarean section, they stay in the hospital for three days. Some women are discharged after two. It is important that you take good care of yourself both in the hospital and at home to speed up your recovery. Most women usually recover from a caesarean section without any problems.

Pain. In the hospital, you will receive pain medication. You may not like it, especially if you are going to breastfeed. But painkillers are needed after the anesthesia wears off to make you feel comfortable. This is especially important in the first few days, when the incision begins to heal. If you are still in pain when you are discharged, your doctor may prescribe pain medication for you to take at home.

Food and drink. In the first hours after surgery, you may only be given ice cubes or a sip of water. When your digestive system will start to work normally again, you will be able to drink more fluids or even eat some easily digestible food. You will know that you are ready to start eating when you can pass gases. This is a sign that your digestive system is awake and ready to get to work. You can usually eat solid food the day after surgery.

Walking. You will most likely be asked to walk around a few hours after the operation, if it is not yet night. You won't want to, but walking is healthy and an important part of your recovery. It will help clear your lungs, improve circulation, speed up healing, and get your digestive and urinary systems back on track. If you are bothered by bloating, walking will bring relief. It also prevents blood clots, a possible postoperative complication.

After the first time, you should take short walks at least twice a day until discharge.

Vaginal discharge. After your baby is born, you will have lochia, a brownish or colorless discharge, for several weeks. Some women after a caesarean section are surprised by the amount of discharge. Even if the placenta is removed during surgery, the uterus must heal, and discharge is part of the process.

Incision healing. The bandage will most likely be removed the day after the operation, when the incision has already healed. While you are in the hospital, the condition of the wound will be monitored. As the incision heals, it will itch. But don't scratch it. It is safer to use lotion.

If the incision was connected with clamps, they will be removed before discharge. At home, take a shower or bath as usual. Then dry the incision with a towel or hair dryer on low heat.

Within a few weeks, the scar will be sensitive and painful. Wear loose clothing that doesn't chafe. If clothing irritates the scar, cover it with a light bandage. Sometimes you will feel twitching and tingling around the incision area - this is normal. While the wound heals, it will itch.

Restrictions. After returning home after a caesarean section, it is important to limit your activities in the first week and take care of yourself and your newborn first of all.

Don't lift heavy things or do anything that puts strain on an unhealed belly. Hold correct posture when standing or walking. Support your belly when you cough, sneeze, or laugh. Use pillows or rolled towels when feeding.
Accept necessary medicines. The doctor may recommend pain medication. If you have constipation or bowel pain, your doctor may recommend an over-the-counter stool softener or mild laxative.
Check with your doctor about what you can and cannot do. Physical exercise can be very tiring for you. Give yourself time to recover. You also had an operation. Many women, when they start to feel better, find it difficult to adhere to the necessary restrictions.
While fast movements hurt, don't drive. Some women recover faster, but usually the period when you should not drive a car lasts about two weeks.
No sex. Abstain until the doctor allows - usually after a month and a half. However, closeness should not be avoided. Spend time with your partner, at least a little in the morning or in the evening when the baby is already asleep.
When the doctor allows, start doing physical exercises. But don't be too zealous. Hiking and swimming - the best choice. 3-4 weeks after discharge, you will feel that you are able to lead a normal normal life.

Possible complications.

Tell your doctor right away about these symptoms if they appear while you are at home:

The temperature is above 38 °C.
Painful urination.
Too much vaginal discharge.
The edges of the wound diverge.
The incision site is red or wet.
Severe pain in the abdomen.

emergency caesarean section

An emergency caesarean section is performed only in case of a threat to the life of the mother or child.

The decision to have an emergency operation or a secondary caesarean section is made only when there really is no other way out, since this is associated with a high risk for the pregnant woman (intubation, bleeding, damage to neighboring organs, infection).

Indications for emergency surgery:

acute hypoxia of the child;
complications that threaten the life of the mother (rupture of the uterus, premature separation of the placenta).

If one of these complications occurs unexpectedly, you need to act very quickly. In the event of a disruption in the supply through the umbilical cord, the doctor has only a few minutes to prevent significant damage to the child's health. The obstetric team must take all measures to ensure that the birth takes place in the next 20 minutes. An interruption in oxygen supply that lasts longer than 10 minutes can damage the baby's brain.

As soon as the doctor decides on an emergency caesarean section, the introduction of anesthesia and the operation are carried out without delay and without long preparation. Surgical intervention can also be carried out in the delivery room, if there is enough space and the necessary equipment.

Women always hope that they will give birth with dignity, that they will be able to endure pain, sometimes even smile when they push for the last time, giving the child life. Many people try very hard to give birth naturally, choosing doctors who have had few cesarean sections in their practice, go to courses for pregnant women, go in for sports during pregnancy, trying to gain only desired weight, sometimes even hiring a doula to be nearby in the delivery room. However, there are a lot of caesarean sections, more than ever before.

How to deal with anxiety

No matter how hard you tried, whether you had normal pregnancy without complications, it may happen that you need an emergency caesarean section. You will be disappointed. Maybe you will feel like a failure. However, it is very important to remain far-sighted. Cesarean section is indeed a risk, as is normal operations, for example, during it, internal bleeding may begin, blood clots may appear, an infection may occur, or damage to internal organs. Some babies have minor breathing problems after a caesarean section. But because surgical techniques and pain management have improved, there are very few hazards associated with caesarean sections, and of course, rhodium, healthy child much more important than trying to give birth naturally.

Reasons for an emergency caesarean section

The most common indication for an emergency caesarean section is an unexpected incorrect position of the child (if it is located legs or buttocks forward) or lateral presentation. Another reason is heavy bleeding that occurred before childbirth and suspicion of premature detachment or placenta previa. The most common reason for caesarean sections is the risk that the baby may not be able to deliver; if the child's cardiogram shows possible deviations, caesarean section will be safe and fast way give a birth to a baby.

Emergency caesarean section procedure

It may happen that everything will happen quickly and chaotically. The lower abdomen will be prepared for the operation. They will wash your belly, maybe shave your hair, and you will be given antibiotics and other intravenous fluids. Anesthesia will be either epidural (with a dose adjusted for caesarean section) or spinal, or maybe even general. If a woman is given an epidural or spinal anesthetic, she will feel nothing from her toes to her chest; while she will be conscious, but will not feel how the doctor makes an incision. Most likely, she will not see this, because a special fence will be put between her and the doctor, or maybe because the baby will be born very quickly.

Caesarean section of the woman's choice

Some healthy women prefer caesarean section at first birth - usually to avoid pain and possible complications during childbirth. Sometimes the doctor will suggest a caesarean section so that the baby will be born at a time that is more convenient for the woman, the doctor, or both.

This caesarean section is not done because of health problems. The reason is fear or a desire to avoid difficulties. And these are not the best reasons for a caesarean section.

However, women are increasingly opting for a caesarean section, and this raises a number of questions.

Is there a limit?

Many women successfully undergo up to three surgeries. However, each next cesarean is more difficult than the previous one. For some women, the risk of complications - such as infection or heavy bleeding- with each caesarean section increases only slightly. If you had a long and difficult labor prior to your first C-section, a second C-section will be physically easier, but the healing process will take just as long. For other women - who have developed large internal scarring - each subsequent caesarean becomes more and more risky.

Repeated cesarean is done by many women. But after the third, you need to weigh the possible risks and your desire to have more children.

Facing the Unexpected

The unexpected news that you need a C-section can be a shock to both you and your partner. Your ideas about how you will give birth will suddenly change. Even worse, this news may come when you are already exhausted from long hours of contractions. And the doctor no longer has time to explain everything and answer your questions.

Of course, you will have concerns about what it will be like for you and your child during the operation, but do not let these fears completely control you. Most mothers and children successfully undergo surgery with a minimum of complications. While you might prefer to have a natural birth, remember that the health of you and your baby is more important than how it was born.

If you have concerns about a planned repeat caesarean section, discuss this with your doctor and partner. This will help you worry less. Tell yourself that you have been through this once before and you can do it again. This time it will be easier for you to recover from the operation because you already know what to expect.

Caesarean section: partner involvement

If the caesarean section is not urgent, requiring general anesthesia, your partner may come into the operating room with you. Some hospitals allow this. Some like the idea, others may be afraid or disgusted. It is generally difficult to be present during the operation, especially when it is done to a loved one.

If the partner decides to attend, he will be given surgical clothes. He can watch the procedure or sit at the head of the bed and hold your hand. Perhaps his presence will make you feel calmer. But there are also difficulties: men sometimes faint, and doctors have a second patient who needs immediate help.

In most maternity hospitals, the baby is photographed and the doctors can even take pictures for you. But in many it is not allowed. Therefore, you should ask permission to take photos or videos.

Cesarean section of choice

Some women who have a normal pregnancy choose to give birth by caesarean section even though they have no complications or problems with the baby. For some of them, it is convenient to precisely plan the date of birth. If you're used to planning everything in your life down to the minute, waiting for an unknown day for your baby's arrival may seem impossible.

Other women choose to have a caesarean section out of fear:

Fear of the birth process and the pain that accompanies it.
Fear of damaging the pelvic floor.
Fear of sexual problems after childbirth.

If this is your first child, childbirth is something unknown and scary. You may have heard horror stories about childbirth and about women who, after childbirth, suffer from urinary incontinence when coughing or laughing. If you've had a vaginal birth before and it didn't go very smoothly, you may be wary of a repeat.

If you are inclined to choose a caesarean section, discuss this frankly with your doctor. If fear is your main motive, talking frankly about what to expect and going to prenatal school can help. If you are told about the horrors of childbirth, politely but firmly say that you will hear about it after your baby is born.

If your previous natural births have been such a terrible story, remember that all births are different and this time may be very different. Think about why the birth was so difficult and discuss it with your doctor or partner. Perhaps something needs to be done to make the experience more positive this time.

If your doctor agrees with your choice, the final decision is yours. If the doctor does not agree and will not perform a caesarean section, he may refer you to another specialist. Learn more about the advantages and disadvantages of both birth methods and discuss them with experts, but don't let fear be the deciding factor.

What should be taken into account?

Elective caesarean section is a tricky thing. Those who are in favor say that a woman has the right to choose how she wants to give birth to her child. Those who oppose believe that the dangers of a caesarean section outweigh any positive sides. On the this moment there is no convincing evidence in the medical literature that the choice of caesarean section is preferable. Good medical practice generally rejects procedures - especially surgical ones - that do not give undoubted benefit to the patient. Moreover, there is little research on this subject.

Since everything is ambiguous, you may find that the opinions of doctors differ greatly. Some are ready for surgery. Others refuse, believing that a caesarean section could be dangerous and thus goes against their vow to do no harm.

The best way to make a decision is to collect as much information as possible. Ask yourself why this option appeals to you. Study the issue, consult with experts and carefully weigh the pros and cons.

Benefit and risk

Many experts believe that modern level development surgical technique a caesarean section is no more dangerous than a conventional birth if this is your first child. If this is the third birth, the situation is different. Caesarean section is more fraught with complications than conventional childbirth. Here is a list of the benefits and dangers of this operation:

Benefits for the mother. Positive Consequences Caesarean section options may include:

Protection against urinary incontinence. Some women fear that the effort required to push the baby through the birth canal can lead to urinary or fecal incontinence and damage to the muscles and nerves of the pelvic floor.
Medical evidence has shown that women who have had a caesarean section have a lower risk of urinary incontinence in the first months after childbirth. However, there is no evidence that this risk is lower 2–5 years after birth. Some women also fear that natural childbirth can cause pelvic organ prolapse, when organs such as the bladder or uterus protrude into the vagina. At the moment there is no clear medical evidence linking caesarean section and reducing the risk of prolapse pelvic organs. But a caesarean section of choice is no guarantee that problems with incontinence and prolapse will not arise at all. The baby's weight during pregnancy, pregnancy hormones, and genetic factors can weaken the pelvic muscles. Such problems can occur even in women who have never had children.
Emergency caesarean section guarantee. An emergency caesarean section, which is usually done during a difficult birth, is much more dangerous than an elective caesarean section or conventional birth. An emergency caesarean is more likely to cause infections, damage to internal organs, and bleeding.
Warranty against difficult childbirth. Sometimes difficult labors require the use of forceps or vacuum suction. Usually these methods are not dangerous. Just as with caesarean section, the success of their use depends on the individual skill of the doctor performing the procedure.
Less problems with the child. In theory, a planned caesarean section could reduce the risk of some problems in the baby. For example, the death of an infant during childbirth, the pathology of childbirth due to wrong position fetus, birth trauma - which is especially important when the baby is very large - and inhalation of meconium, which occurs if the baby began to defecate before birth. It also reduces the risk of paralysis. However, it is important to remember that the risk of all these complications is quite low with conventional births, and a caesarean section is no guarantee that these problems will not occur.
Less risk of transmission of infections. A caesarean section reduces the risk of mother-to-child transmission of infections such as AIDS, hepatitis B and C, herpes, and papillomavirus.
Establishment exact date childbirth. If you know exactly when the baby is due, you can better prepare. It is also convenient for planning the work of the medical team.

Risk to the mother immediately after surgery

Certain inconveniences and dangers are associated with caesarean section. It will take longer to stay in the hospital. The average length of stay in the hospital after a caesarean is three days, after a normal birth - two.

Increased chance of infection. Because it is a surgical operation, the risk of infection after a caesarean is higher than after a conventional birth.

Postoperative complications

Since a caesarean section is an abdominal operation, certain risks are associated with it, such as infection, poor healing of stitches, bleeding, damage to internal organs, and blood clots. The risk of complications after anesthesia is also higher.

Reducing the possibility of early connection with the child and the beginning breastfeeding. For the first time after the operation, you will not be able to take care of the child and breastfeed him. But this is temporary. You will be able to bond with your baby and breastfeed as soon as you recover from the surgery.

Insurance payment

Your insurance may not cover a caesarean section of choice, and it will cost more than a conventional birth. Before making a decision, check if this operation is covered by your insurance.

Risks for the mother in the future

After a caesarean section, the following troubles are possible in the future:

future complications. With multiple pregnancies, the likelihood of complications increases with each subsequent pregnancy. Repeated cesarean sections further increase this likelihood. Most women can safely have up to three surgeries. However, each subsequent one will be more difficult than the previous one. For some women, the risk of complications such as infection or bleeding increases only slightly. For others, especially those who have large internal scarring, the risk of complications with each subsequent caesarean section increases very significantly.

Rupture of the uterus in the next pregnancy. A caesarean section increases the risk of uterine rupture in the next pregnancy, especially if you choose to have a normal birth this time. The probability is not very high, but you should discuss this with your doctor.

Problems with the placenta. Women who have had a caesarean section have a higher risk of placental disorders, such as presentation, in subsequent pregnancies. In previa, the placenta closes the opening of the cervix, which can lead to preterm labor. Placenta previa and other related disorders caused by caesarean section greatly increase the risk of bleeding.

Increased risk of hysterectomy. Some placental problems, such as placenta accreta, where the placenta is attached too deeply and firmly to the wall of the uterus, may require removal of the uterus (hysterectomy) at birth or soon after.

Damage to the intestines and bladder. Serious damage to the intestines and bladder during caesarean section is rare, but they are much more likely than during conventional births. Complications associated with the placenta can also lead to bladder damage.

Dangers for the fetus

Dangers for the child associated with a caesarean section:

Respiratory disorders. One of frequent violations in a child after a caesarean section, this is a slight breathing disorder called tachypnea (rapid shallow breathing). This happens when there is too much fluid in a child's lungs. When the baby is in the uterus, her lungs are normally filled with fluid. In normal childbirth, advancement along birth canal squeezes chest and naturally pushes fluid out of the baby's lungs. With a caesarean section, this compression does not occur, and fluid may remain in the baby's lungs after birth. This results in rapid breathing and usually requires a pressurized supply of oxygen to remove fluid from the lungs.
Immaturity. Even a little immaturity can have a very negative impact on the child. If the due date is inaccurate and the caesarean section is too early, the baby may have complications associated with prematurity.
Cuts. During a caesarean section, the baby may get cut. But this rarely happens.

Decision-making

If your doctor does not accept your request for a caesarean section, ask yourself why. Physicians and surgeons must avoid unnecessary medical interventions especially if they can be dangerous. The lack of scientific evidence to support elective caesarean section makes this operation unnecessary. Although, from the doctor's point of view, ease of planning, efficiency, and financial rewards favor a caesarean section, a doctor you trust should be at least reticent about this operation.

Around the world, there is a clear trend towards gentle delivery, which allows you to save the health of both mother and child. A tool to help achieve this is the caesarean section (CS). A significant achievement has been wide application modern methods of anesthesia.

The main disadvantage of this intervention is the increase in the frequency of postpartum infectious complications by 5-20 times. However, adequate antibiotic therapy significantly reduces the likelihood of their occurrence. However, there is still debate about when a caesarean section is performed and when physiological delivery is acceptable.

When is operative delivery indicated?

A caesarean section is a major surgical procedure that increases the risk of complications compared to normal natural childbirth. It is carried out only by strict indications. At the request of the patient, CS can be performed at private clinic, but not all obstetrician-gynecologists will undertake such an operation unnecessarily.

The operation is performed in the following situations:

1. Full presentation placenta - a condition in which the placenta is located in the lower part of the uterus and closes the internal os, preventing the baby from being born. Incomplete presentation is an indication for surgery when bleeding occurs. The placenta is abundantly supplied with blood vessels, and even a slight damage to it can cause blood loss, lack of oxygen and fetal death.

2. Occurred ahead of time from the uterine wall - a condition life threatening woman and child. The placenta detached from the uterus is a source of blood loss for the mother. The fetus ceases to receive oxygen and may die.

3. Previously transferred surgical interventions on the uterus, namely:

at least two caesarean sections;
a combination of one CS operation and at least one of the relative indications;
removal of intermuscular or on a solid basis;
correction of the defect in the structure of the uterus.

4. Transverse and oblique positions of the child in the uterine cavity, breech presentation (“booty down”) in combination with the expected weight of the fetus over 3.6 kg or with any relative indication to operative delivery: a situation where the child is located at internal os not the parietal region, but the forehead (frontal) or face (facial presentation), and other features of the location that contribute to birth trauma The child has.

Pregnancy can occur even during the first weeks of the postpartum period. calendar method contraception under conditions irregular cycle not applicable. The most commonly used condoms are mini-pills (progestin contraceptives that do not affect the baby while breastfeeding) or conventional (in the absence of lactation). Use must be excluded.

One of the most popular methods is . The installation of a spiral after a cesarean section can be performed in the first two days after it, but this increases the risk of infection, and is also quite painful. Most often, the spiral is installed after about a month and a half, immediately after the onset of menstruation or on any day convenient for a woman.

If a woman is over 35 years old and has at least two children, at her request, the surgeon can perform surgical sterilization, in other words, dressing fallopian tubes. This is an irreversible method, after which conception almost never occurs.

Subsequent pregnancy

Natural childbirth after caesarean section is allowed if the formed connective tissue on the uterus is wealthy, that is, strong, even, able to withstand muscle tension during childbirth. This issue should be discussed with the supervising physician during the next pregnancy.

The likelihood of subsequent births in a normal way increases in the following cases:

a woman has given birth to at least one child through natural means;
if CS was performed due to malposition of the fetus.

On the other hand, if the patient is over 35 at the time of her next birth, she has excess weight, concomitant diseases, mismatched sizes of the fetus and pelvis, it is likely that she will again undergo surgery.

How many times can a caesarean section be done?

The number of such interventions is theoretically unlimited, however, to maintain health, it is recommended to do them no more than twice.

Usually the tactics repeated pregnancy next: a woman is regularly observed by an obstetrician-gynecologist, and at the end of the gestation period, a choice is made - surgery or natural childbirth. In normal childbirth, doctors are ready to perform an emergency operation at any time.

Pregnancy after caesarean section is best planned with an interval of three years or more. In this case, the risk of insolvency of the suture on the uterus decreases, pregnancy and childbirth proceed without complications.

How soon can I give birth after surgery?

It depends on the consistency of the scar, the age of the woman, concomitant diseases. Abortions after CS adversely affect reproductive health. Therefore, if a woman nevertheless became pregnant almost immediately after a CS, then with the normal course of pregnancy and constant medical supervision she can bear a child, but the delivery will most likely be operative.

The main danger early pregnancy after the COP is the failure of the suture. It is manifested by increasing intense pain in the abdomen, the appearance of spotting from the vagina, then there may be signs internal bleeding: dizziness, pallor, fall blood pressure, loss of consciousness. In this case, you must urgently call an ambulance.

What is important to know about the second caesarean section?

A planned operation is usually performed in the period of 37-39 weeks. The incision is made along the old scar, which somewhat lengthens the operation time and requires stronger anesthesia. Recovery from CS may also be slower, as scar tissue and adhesions in the abdominal cavity prevent good cut uterus. However, when positive attitude the woman and her family, the help of relatives, these temporary difficulties are quite surmountable.

In oriental legends, a legend is described that the future hero of Persia Rustem could not be born, the sacred bird Simurg gave advice: wine, a dagger cut and stroking the cut with the feather of the bird Simurg. In myths Ancient Greece the future patron of medicine Esculalap was saved from intrauterine death only thanks to Apollo, who snatched the child from the womb of an already dead mother.

At the end of the 7th century, a law was in force in Rome, according to which dead pregnant women could be buried after the extraction of the child. This operation was practiced only on dead women.

In Switzerland, there is evidence that the first caesarean section was performed on the wife of Jacob Nyfer in 1500. The woman already had 5 children, but she gave birth to the sixth for too long and her husband, having received the consent of the city council, literally opened his wife. Both mother and child were saved. This was not her last child, the woman gave birth to five more children, one of the births ended in the birth of twins. By the way, her husband, according to the manuscripts, was engaged in the castration of boars. This case is not officially recognized, since data in the historical literature appeared only 82 years after the operation.

In the 16th century, the French doctor Ambroise Pare was the first to perform an operation on a living woman. He managed to save many children, but the women were dying. The fact is that the incision on the uterus was not sewn up, women had massive bleeding or an infection joined. Dr. Trautmann managed to save the life of a woman, for this reason his name is most often listed as the name of the first doctor who performed a successful caesarean section. The woman died a month after the operation, but not from postoperative complications. In Russia, the first section was carried out by Dr. Erasmus in 1756.

First and the only woman, who made herself a caesarean section herself, was the Mexican Ines Ramirez. In 2000, already the mother of seven children, Ines gave birth for the ninth time (one of the children, alas, died). Realizing that something was going wrong and realizing that there was no help coming from anywhere ─ her husband was celebrating a holiday, there was no midwife in the settlement, and the phone was too far away ─ the woman made a desperate decision. After drinking several portions of alcohol, she cut open her stomach with a kitchen knife, without injuring either the child or internal organs, removed her son and cut his umbilical cord. A little later, after regaining consciousness, she was able to stop the bleeding and ask her son to help her. A six-year-old boy found a veterinarian's assistant who sewed up the wound with ordinary sewing thread. And only after 16 hours Ines got to the hospital. In 10 days she was already at home. Doctors call it a miracle, and Inez - God's providence.

Why a caesarean section

One version says that one of Caesar's ancestors was born this way. Another argues that a cesarean section is due to the law according to which a child must be removed from the womb of a dead or dying woman (from the Latin Lex Caesarea ─ the law of the king). At the same time, in

Encyclopedic YouTube

1 / 5

Caesarean Section 2.wmv

Caesarean section 1.wmv

Caesarean section according to Joel-Cohen

C-SECTION. Childbirth without fear. Issue 77

Subtitles

Operation history

According to information that has come down to the present day, caesarean section is one of the most ancient operations. The myths of Ancient Greece describe that with the help of this operation, Asclepius and Dionysus were extracted from the womb of dead mothers. In Rome, at the end of the 7th century BC, a law was issued according to which the burial of a dead pregnant woman was carried out only after the child was removed by ablation. Subsequently, this manipulation was performed in other countries, but only for dead women. In the 16th century, Ambroise Pare, the court physician of the French king, first began performing caesarean sections on living women. But the outcome was always fatal. The mistake of Pare and his followers was that the incision on the uterus was not sewn up, counting on her contractility. The operation was performed only to save the child, when the mother's life could no longer be saved.

It was only in the 19th century that it was proposed to remove the uterus during surgery; as a result, mortality decreased to 20-25%. Five years later, the uterus began to be sewn up with a special three-story suture. This is how it started new stage caesarean section operations. It began to be performed not only for the dying, but also in order to save the life of the woman herself. With the beginning of the era of antibiotics in the middle of the 20th century, the outcomes of the operation improved, and deaths during it became rare. This was the reason for the expansion of indications for caesarean section both on the part of the mother and on the part of the fetus.

Indications

Planned caesarean section

A planned caesarean section is an operation, the indications for which are determined before the pregnancy is resolved. This category also includes optional caesarean section. In a planned CS, the incision is made horizontally. The indications are:

The discrepancy between the size of the pelvis of a woman and the size of a child
Placenta previa - the placenta is located above the cervix, blocking the way out for the baby
Mechanical obstructions that interfere with natural childbirth, such as fibroids in the cervix
Threatened rupture of the uterus (scar on the uterus from a previous birth)
Diseases not associated with pregnancy, in which natural childbirth poses a threat to the health of the mother (diseases of the cardiovascular system, kidneys; history of retinal detachment)
Complications of pregnancy that pose a threat to the life of the mother during childbirth (severe preeclampsia - eclampsia)
Breech presentation or transverse position of the fetus
Multiple pregnancy
genital herpes at the end of pregnancy (the need to avoid contact of the child with the genital tract)

emergency caesarean section

An emergency caesarean section is an operation performed when complications arise during natural childbirth that threaten the health of the mother or child. In an emergency CS, the incision is usually made vertically. Possible reasons:

Sluggish generic activity or complete cessation
Premature abruption of a normally located placenta (the supply of oxygen to the fetus is cut off and potentially fatal bleeding)
(Threatening) uterine rupture
Acute hypoxia (lack of oxygen in a child)

Contraindications

Intrauterine fetal death
Fetal malformations incompatible with life.

Anesthesia

Caesarean section is usually (up to 95% of cases) performed under regional (epidural or spinal anesthesia, or a combination of them) anesthesia. It only relieves Bottom part body, a woman can immediately after removing the child from the uterus, take it in her hands and attach it to her chest.

In the case of an emergency caesarean section, sometimes you have to resort to general anesthesia.

Operation

Before surgery, the pubis is shaved and a catheter is inserted into the bladder to empty it. An empty bladder will not put pressure on the uterus, which will contribute to its better contraction in postpartum period. And also there will be less chance of damage during the operation. After anesthesia, the woman is placed on operating table and fence off upper part torso screen.

After operation

The day after the operation, round-the-clock monitoring of the woman's condition is carried out. An ice pack is placed on the abdomen to contract the uterus and stop bleeding, and painkillers, drugs that promote uterine contraction, and drugs to restore the function of the gastrointestinal tract are prescribed. Antibiotics are also sometimes prescribed. Currently, it is believed that if there is no ongoing bleeding, then intravenous fluids are not needed and even harmful, as they cause swelling of the intestinal wall. The earliest possible activation (up to 4-6 hours after surgery) with sufficient pain relief, early start fluid and food intake (the concept of Fast Track Recovery) has been proven to reduce the rehabilitation time after surgery and several times reduce the number of postoperative complications.