Methods of cesarean section

The article was consulted professionally by Specialist I Pham Thi Yen – Obstetrics and Gynecology Department – Share99 Hai Phong International Health Hub

To date, vaginal birth is still a method recommended by obstetrician and gynecologist. However, for women who cannot give birth often, pregnancy surgery is a reasonable choice.

Pregnancy surgery is a case of taking the fetus and placenta out of the uterus through the incision of the abdominal wall and incision of the uterus. This definition does not include opening the abdomen to the pregnancy in case the pregnancy is lost in the abdomen and the rupture of the uterus is already in the abdomen.

Regarding cesarean sections, currently doctors often make cross-incisions under the uterus for pregnancy, so the surgery is called "lower segment horizontal surgery", however in some cases, if the lower segment is well established, it is possible to make an incision along the lower segment. Today, the method of lower segment surgery is the main technique of choice in most obstetrics and gynecology facilities worldwide.

Previously, when the operation necessarily closed the peritoneal covering of the incision in the lower segment, the doctor even carefully pulled each flap of the peritonea above and below the incision across the lower segment so that the incision was twice covered. Similarly, the abdominal wall mescosa is also sewn tightly before closing the abdomen. Currently, many places have abandoned the closure of the uterus and abdominal wall mesitoneeas because it is believed that it is not necessary, theitone will stick itself back after 24 hours of surgery, helping to minimize abnormalities caused by self-destruction (bacterial infections, allergies); the re-operation time is shortened.

Regarding the incision line on the abdomen, previously, people only cut the skin along the longitudinal line from the navel or on the bottom of the navel a little down to the pubic area. However, doctors now use a horizontal incision on the pubic bone to prevent surgical scars from running along the abdominal wall. In addition to the aesthetic effect, this incision also has the effect of firming the abdominal wall in the incision because the outside of the incision is horizontal but inside, when opening the abdominal wall muscle layer, people follow the vertical line.

• Caused by pregnancy.
  • Inlets due to abnormal pregnancy: the horizontal throne, the forehead, the back chin, the front one..
  • Big pregnancy
  • Impaired pregnancy
  • Pathology of pregnancy with contraint contraceptive vaginal calving
• Due to the causes of the sub-part of the pregnancy: Placenta clings to the edge, each other clings to the center …
• Due to genital causes: the vagina has a septum, 2 uterus …
• Due to m mother's pathology: severe pre-production, cardiovascular disease …
• Other indicators

First, the maternity will be fully explained by the medical staff the reason for the pregnancy surgery, signing the surgical commitment. After that, will be peeing, antiseptic abdominal wall, spread harmless towels after having been pain relief.

The steps include:

Then one. Abdominal opening:

• It is possible that the middle white line under the navel or the horizontal line on the pubic.
• Reveal the operating area: insert gauze, put a protective valve.

Then 2. Open the mescosa of the segment under the uterus.

Then three. Incision across the lower muscles of the uterus to the amniotic membrane:

• Open the segment under the uterus in the middle (note to avoid touching the pregnancy section just below). Extend the incision of the uterus to the sides. The opening line of the uterus parallel to the lower segmenteal opening line.
• The line crosses the lower section about 8-10cm.

Then four. Pregnancy and vegetables:

• Pregnancy: take the pregnancy if it is the head, take the pregnancy leg or the buttocks if the rest of the throne.
• Use a thin gauze to wipe the baby's mouth.
• Clamp and cut the umbilical cord.
• Intravenously slow (via infusion) 10 units of oxytocin. Take the vegetables by pulling the umbilical cord and pressing the bottom of the uterus through the abdominal wall. Clean the uterus. Cervical nong if necessary.
• Check and clamp the large blood vessels that are flowing.

Then 5. Stitches of the uterus and mesitoneal incisions:

• The restoration of the muscle layer of the uterus with the no. 1 target. It is possible with a separate nose or a locked squeeze or no lock. Stitches take the entire thickness of the muscle layer of the uterus.
• It is not recommended to stitch the whole endometrial layer. Usually sewing a layer is enough. If necessary, squeeze the second layer to prevent bleeding and cover the first stitch.
• Lower-uterus mescosa is required when there is a risk of infection.

Then 6. Wipe the abdomen, examine the uterus, the appendix and surrounding organs, count enough gauze

Then 7. Close the abdominal wall in layers.

Eight. Take blood and wipe the vagina.

5.1. Post-surgery monitoring

• Vessels, blood pressure, total condition, excretion of urine.
• Contraction of the uterus, the amount of blood flowing from the uterus.
• Abdominal wall incision.
• Medium.

5.2. care

• Women are given painkillers after surgery.
• Women are given early to drink and eat (drink, liquid food when not yet convenient, eat normally when there is a mediaity).
• Early movement.
• Early lactation.
• The doctor prescribes antibiotics for treatment (if necessary).

6.1. On the mother's side

6.1.1.Near-accident

• Infection: commonly an incision infection, urinary tract infections
• Surgical complications such as touching neighboring organs (bladder, intestines), ureteral stitches, bladder fistula – uterus/vagina.
• Severe bleeding, blood bandages during or after surgery due to uterine sputum; bleeding from tearing of the lower uterus.
• Intestinal paralysis.
• Expand the incision, hernia of the abdominal wall.
• Internal bleeding.
• Venous embolism, thrombosis.
• Mage death: may be caused by amniotic embolism, unstypable bleeding or insufficient blood when the mother belongs to a rare blood type.
• Complications caused by anesthesia – resuscitation: there may be complications due to insymity such as inhalation syndrome (in case of intt management anesthesia); hypotension,post-surgery headache (in case of spinal anesthesia), drug reactions (anaesthetic stunting).

6.1.2.Distant accidents

• Intestinal obstruction, intestinal obstruction.
• Obstruction of the ovulation of the ovulation causes second-born infertility.
• Endometriosis at cesarean scars or abdominal wall scarring.
• During later pregnancies, scars on the body of the uterus may crack (cracking before labor or labor)
• In later pregnancies, the likelihood of having to have a caesarean section increases and if a vaginal fall is born with suction or forceps to reduce the risk of cracking old surgical scars on the lower part of the uterus…

6.2. On your side

• The fetus may be affected by anesthesia.
• Injured during surgery.
• Inhalation of amniotic fluid, especially amniotic fluid with feces.
• Babies born to cesarean section are at risk of severe respiratory failure (pulmonary absorption delay syndrome) and are life-threatening due to intervention when the mother has not yet labored, especially the child is given a caesarean section at an insufficient gestation period (before 39 weeks).
• Perstal death (within 28 days after birth) in the case of cesarean section is higher than in normal birth.
• Cesarean section also increases the risk of the child dying at birth at the next childbirth (it is possible that the uterus scarred due to the last operation does not create conditions for each other to stick well so that the blood supply and nutrients that feed the fetus are inadequate)…

At Share99 International Health Hub, there is a full maternity service as a solution to help pregnant mothers feel secure because there is a team of doctors throughout the pregnancy. When choosing a full-service maternity, a pregnant woman can:

• The process of pregnancy is monitored by a team of specialists
• Regular examination, early detection of abnormalities
• Package maternity for the convenience of childbirth
• Infants receive comprehensive care