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2. Lower Segment Caesarean Section- In this case, the uterus is opened in the lower
segment and the babys head or breech as the case may be is delivered.
Indications:
Spinal Anesthesia is the commonest type of anesthesia used the world over
because of its ease of administration, safety for the mother and the baby, and early
return to normal activities including feeding the baby by the mother.
2. The muscles over this region are incised and then the uterus is opened at its
lower portion. (Hysterotomy). Before the uterus is opened, care in taken not to
injure the urinary bladder, which lies very close to the uterus at this point. The
bladder is pushed downward and away from the area to be operated.
3. Once the uterus has been opened, the waters surrounding the baby is sucked out
and then the surgeon passes his hand into the uterus and grasps the presenting
part of the baby. This is the lowermost part of the baby present within the uterus-it
could be the babys head or breech, or occasionally its back.
Once the presenting part is within the doctors grasp, he gently pulls the baby out.
The babys mouth is immediately sucked to remove any water it may have
swallowed.
4. The umbilical cord is then clamped and cut to free the baby from the mother. The
baby is wrapped and taken under the pediatrician's care. The delivery of the baby in
a Cesarean section is accomplished in about 5 minutes or less to minimize the
effect of anesthesia and surgery on the baby.
5. Meanwhile, the placenta or after-birth is then removed from the mother's uterus.
The inside of the uterus is wiped clean to remove any bits of placental membrane
sticking to it. The opening in the uterus is then stitched up.
6. At this point the obstetrician may request the anesthetist to administer medicines
it shrink the expanded uterus quickly in size, almost to the pre-pregnancy level. This
will ensure that there is less bleeding from the uterus.
7. The abdomen is then closed and a sterile dressing is applied over the incision.
8. The mother is recovered from anesthesia and moved out of the operating theatre.
She is allowed to commence breast-feeding as early as possible.
Even though Caesarean as a surgical procedure has become a safe procedure in the
right hands, complications can arise during or after the operation.
4. Aspiration or inhalation of the contents of the stomach into the lungs during
anesthesia is the most dreaded complication of general anesthesia during a
caesarean section. This can be avoided to some extent by ensuring a minimum
starvation period of six hours for solid food and milk. This precaution may have to
be bypassed during an emergency
5. Amniotic fluid embolism is entry of amniotic fluid from the mother's womb into
the blood stream and then into the lungs. This complication carries a very high
mortality but fortunately it is also very rare. It cannot be prevented.
1. Bleeding
3. Thrombosis or clot formation in the large veins of the leg or hips can occur. If
these clots get dislodged from the leg and move into the lung, they can cause a
fatal complication called pulmonary embolus
4. Ileus or paralysis of the bowels for a couple of days which then recovers.
The patient is given antibiotics to prevent infection, painkillers to combat the pain,
medicines to counter the vomiting tendency, as well as medicines to shrink the
uterus to normal size.
After 24 hours she can start moving around and can even commence on a soft
diet.
The sutures are removed on the 4th day and if all is well, the mother is allowed to
go home.
Each individual requires 3-4 weeks to get back to normal. The mother can resume
normal activities after about a month.