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Cesarean Section - Multi Specialty Hospital | Bangalore Orthopaedic and Surgical Hospital | BOSH | Bangalore

A cesarean section, also called a C-section, is surgery to deliver a baby through the abdomen. It's used when:

  • medical It's impossible or not advised to deliver the baby through the vagina, or
  • medical Continuing in labor seems to present a greater risk to the health of the baby or mother, even if the plan was a vaginal delivery

A C-section sometimes is scheduled in advance. But it may also be unscheduled as circumstances change in the course of labor and delivery. An unscheduled cesarean is not the same as an emergency cesarean, which is done when there is immediate risk to a mother or baby that cannot be resolved without immediate delivery.

Reasons related to a mother's health that may lead to a C-section include

  • medical Past surgeries involving the uterus. The most common such surgery is a past C–section in the thick part of the uterus, a so-called classical cesarean. These are the minority of cesareans however. And many women can try to deliver a baby vaginally after a previous C-section.
  • medical Infection. If a mother has an infection that may be passed on to the baby during a vaginal delivery, that's another case when a C-section would be recommended. In some women with HIV or genital herpes, for example, cesarean delivery may be recommended to minimize the risk of the baby being infected during the course of labor and delivery.

Reasons for cesarean delivery related to the baby's condition include:

  • medical Breech position (hips or legs positioned in front of the head)
  • medical PaMultiple gestation (delivering triplets or a greater number of multiples vaginally is complex, especially if all are not head-first)
  • medical Evidence that the baby is not tolerating the process of labor (for example, changes in the fetal heart rate with contractions)

Reasons for cesarean delivery related to the pregnancy include:

  • medical Abnormal position of the placenta (for example, the placenta covers the cervix, a condition known as placenta previa)
  • medical Failure of the cervix to dilate during labor
  • medical Failure of the baby to descend through the birth canal during labor and pushing.

Procedure:

A low, horizontal skin incision is made in the abdomen at or just above the pubic hairline. Rarely, a vertical incision is required. This is sometimes used in an emergency situation as it may be slightly faster.

After the abdomen is opened, the bladder is protected from injury, and the uterus is opened. The incision in the uterus is usually horizontal and low in the uterus. Or it may be vertical. A vertical incision is preferred when a larger uterine incision is needed, or if the lower part of the uterus has not developed or stretched enough to permit a low horizontal incision. A vertical incision is often needed to perform a preterm cesarean delivery. The bag of waters is broken, the baby is delivered, and the umbilical cord is clamped and cut.

The time from the beginning of surgery to delivery of the baby generally is less than 10 minutes, but may be longer if it is not a first cesarean and there is scarring from a past procedure, or if a woman is particularly heavy. Once the baby is delivered, it can take another 30 to 40 minutes to remove the placenta and close the uterus and abdomen with stitches or staples. The entire surgery usually takes just under an hour.

Risks:

The most common problems following cesarean delivery are:

  • medical Bleeding (hemorrhaging)
  • medical Infection of the uterine lining (endometritis)r
  • medical Injury to other pelvic organs, such as the bowel or bladder

Risks to the baby include:

  • medical Skin cuts made during the uterine incision
  • medical Delay in absorbing amniotic fluid from the lungs

There are also possible complications from anesthesia. General anesthesia provides deep, total relaxation of the body, which can lead to stomach acids flowing into the woman's lungs. This is a rare complication. The after-effects of general anesthesia can also make the mother and baby sleepy and delay mother-infant bonding. Headache may occur after regional anesthesia, whether this is used for cesarean delivery or pain management in labor.