Al-Ain University

College of Medicine

Research title
Cesarean section

Done by
‫روان ميثم جواد‬

Under supervision of

Assist Prof Dr. Muslim N. Saeed.

 Al-Ain University
College of Medicine

Table of Contents
Summary....................................................................................................................................................... 3
INTRODUCTION....................................................................................................................................... 4
Reasons for a planned caesarean section .................................................................................................. 5
Reasons for an unplanned caesarean section ........................................................................................... 5
Risks and complications of a caesarean section ............................................................................ 6
When is a cesarean delivery needed .......................................................................................................... 7
How is a cesarean delivery done ................................................................................................................ 8
After a cesarean section surgery ................................................................................................................ 9
References .................................................................................................................................................. 11
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Summary
Cesarean section (C-section) is a surgical procedure that involves delivering a baby
through an incision made in the mother's abdomen and uterus. Over the years, C-
sections have become increasingly common and are now the most prevalent
surgery in the United States, with more than one million women undergoing the
procedure annually. The decision to perform a C-section can be planned or
unplanned, depending on various factors such as the mother's health and the baby's
position and condition.
Planned C-sections are scheduled in cases where a previous C-section has
occurred, the baby is in a breech position, there is placenta previa or other
complications. Unplanned C-sections may be necessary if labor is not progressing,
the baby is showing signs of distress, or the mother's health is at risk. However, C-
sections come with potential risks and complications, including infection, blood
loss, blood clots, adhesions, longer recovery time, future pregnancy complications,
anesthesia complications, and delayed bonding between mother and baby.
During a C-section, the mother is given anesthesia to numb the lower half of her
body or to put her to sleep. The surgeon then makes an incision in the mother's
abdomen and uterus, delivers the baby, removes the placenta, closes the incision,
and closely monitors the mother for any postoperative complications. While C-
sections can be life-saving in certain situations, efforts are being made to reduce
their rate. However, experts predict that a significant drop in the C-section rate
may not occur for at least a decade or two.
It is important for women to understand the reasons for planned and unplanned C-
sections, as well as the potential risks and complications associated with the
procedure. Healthcare providers play a crucial role in guiding women through the
decision-making process and providing appropriate care before, during, and after a
C-section.
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INTRODUCTION
Cesarean section is a fetal delivery through an open
abdominal incision (laparotomy) and an incision in the
uterus (hysterotomy). The first cesarean documented
occurred in 1020 AD, and since then, the procedure has
evolved tremendously. It is now the most common
surgery performed in the United States, with over 1
million women delivered by cesarean every year. The
cesarean delivery rate rose from 5% in 1970 to 31.9%
in 2016. Though there are continuing efforts to reduce
the rate of cesarean sections, experts do not anticipate a
significant drop for at least a decade or two. While it
confers risks of both immediate and long-term
complications, for some women, cesarean delivery can
be the safest or even the only way to deliver a healthy
newborn.
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Reasons for a planned caesarean section

There are several reasons why you and your obstetrician may decide on a planned
(elective) caesarean birth.
These include:
• You have previously had a caesarean section.
• Your baby is positioned bottom or feet first (breech) and can’t be turned.
• Your cervix (opening to the womb) is blocked by the placenta (this is known
as placenta previa).
• Your baby is lying sideways (transverse) and is not able to be turned by the
doctor.
• You have a twin pregnancy, with your first baby positioned bottom or feet
first.
• You are having 3 or more babies.
Reasons for an unplanned caesarean section
Some of the reasons for an unplanned (emergency) caesarean birth include:
• Your baby's head does not move down or ‘fit’ through your pelvis during
labour.
• Your labour does not progress – your contractions are not strong enough and
your cervix opens too slowly or not at all.
• Your baby shows signs of distress or their health is being compromised.
• The umbilical cord, which provides important nutrients and oxygenated
blood to your baby, has fallen down (prolapsed) through the cervix and into
the vagina after your waters have broken.
• A health problem, such as high blood pressure, is making labour riskier for
you and your baby.
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Risks and complications of a caesarean section

While C-sections can be life-saving for both mother and baby in certain situations,
they also come with risks and potential complications. In this report, we will
discuss the risks associated with C-sections.

1. Infection: C-sections are associated with a higher risk of infection than

vaginal deliveries. This is because the surgery creates an open wound in the
mother's abdomen, which can become infected with bacteria. Infections can
be mild or severe and may require antibiotics or additional surgery to treat.

2. Blood loss: C-sections typically result in more blood loss than vaginal
deliveries. Excessive blood loss can lead to anemia, blood transfusions, or
other complications.

3. Blood clots: C-sections increase the risk of blood clots, which can be life-
threatening if they travel to the lungs or brain. Women who have a C-section
are often given blood thinners to reduce the risk of blood clots.

4. Adhesions: C-sections can cause scar tissue to form in the abdomen, which
can lead to adhesions. Adhesions are bands of scar tissue that can cause
organs to stick together, leading to pain, bowel obstruction, or infertility.

5. Longer recovery time: C-sections typically require a longer recovery time

than vaginal deliveries. Women who have a C-section may experience pain,
discomfort, and difficulty with activities of daily living for several weeks
after surgery.
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6. Future pregnancy complications: Women who have a C-section are at

increased risk of complications in future pregnancies, including placenta
previa, placenta accreta, and uterine rupture.

7. Anesthesia complications: C-sections require anesthesia, which can cause

complications such as allergic reactions, breathing difficulties, or low blood
pressure.

8. Delayed bonding: C-sections can interfere with the bonding process

between mother and baby. Women who have a C-section may not be able to
hold their babies immediately after birth and may have difficulty
breastfeeding.

When is a cesarean delivery needed

While vaginal delivery is the preferred method of delivery for most pregnancies,
there are situations where a C-section may be necessary for the health and safety of
the mother and baby. In this report, we will discuss when a C-section may be
needed.
1. Failure to progress in labor: If labor is not progressing as it should, a C-
section may be necessary. This can happen if the cervix is not dilating or if
the baby is not descending into the birth canal.
2. Fetal distress: If the baby is showing signs of distress, such as an abnormal
heart rate, a C-section may be necessary to deliver the baby quickly and
safely.
3. Abnormal presentation: If the baby is not in the head-down position, a C-
section may be necessary to avoid complications during delivery.
4. Placenta previa: If the placenta is covering the cervix, a C-section may be
necessary to avoid bleeding and other complications during delivery.
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5. Placental abruption: If the placenta separates from the uterus before delivery,
a C-section may be necessary to deliver the baby quickly and prevent
complications.
6. Multiple pregnancies: If a woman is carrying twins or other multiples, a C-
section may be necessary if the babies are not in the head-down position or
if there are other complications.
7. Maternal health conditions: If a woman has certain health conditions, such
as high blood pressure, heart disease, or diabetes, a C-section may be
necessary to reduce the risk of complications during delivery.
8. Previous C-section: If a woman has had a previous C-section, she may need
to have another C-section for subsequent deliveries, depending on the reason
for the previous C-section and other factors.

How is a cesarean delivery done

Cesarean delivery, commonly known as a C-section, is a surgical procedure in
which a baby is delivered through an incision made in the mother's abdomen and
uterus. The procedure is typically performed under regional or general anesthesia
and involves several steps. In this report, we will discuss how a C-section is done.

1. Anesthesia: Before the surgery begins, the mother is given anesthesia to

numb the lower half of her body or to put her to sleep. This is done to
eliminate pain and discomfort during the surgery.

2. Incision: Once the anesthesia takes effect, the surgeon makes an incision in
the mother's abdomen and uterus. The incision can be either vertical or
horizontal, depending on the reason for the C-section and other factors.
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3. Delivery of the baby: After the incision is made, the surgeon gently lifts the
baby out of the uterus and delivers it through the incision.

4. Placenta delivery: After the baby is delivered, the surgeon removes the
placenta from the uterus and checks for any remaining tissue.

5. Closing the incision: The surgeon then closes the incision in the uterus with
sutures or staples and closes the incision in the abdomen with stitches or
staples. A sterile dressing is then applied to the incision site.

6. Post-operative care: After the surgery, the mother is taken to a recovery

room where she is closely monitored for any complications. Pain
medications are given as needed, and the mother is encouraged to move
around as soon as possible to promote healing.

After a cesarean section surgery

After a cesarean section (C-section) surgery, the mother enters a phase of recovery
and postoperative care:
1. Monitoring: The mother is closely monitored in a recovery room for a few
hours after the surgery. Vital signs, such as blood pressure and heart rate, are
regularly checked to ensure stability.
2. Pain management: Pain medications are provided to alleviate discomfort and
manage pain. The type and dosage of pain relief may vary depending on the
individual's needs and the healthcare provider's recommendations.
3. Incision care: The incision site is kept clean and dry. A sterile dressing may
be applied to protect the wound and promote healing. It's essential to follow
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the healthcare provider's instructions for caring for the incision, such as how
to clean it and when to change the dressing.
4. Physical mobility: Early mobilization is encouraged to prevent
complications and aid in recovery. Walking and gentle movements, as
guided by the healthcare provider, help promote blood circulation and
prevent blood clots.
5. Breastfeeding: If the mother intends to breastfeed, she can start doing so as
soon as she is comfortable. Different positions may be needed to
accommodate the incision site and ensure comfort during nursing.
6. Postpartum care: The mother will receive postpartum care, which may
include assistance with breastfeeding, guidance on postpartum exercises, and
emotional support. Regular check-ups with the healthcare provider are
scheduled to monitor the healing process and address any concerns.
7. Recovery timeline: The recovery time varies for each individual, but most
women can expect to stay in the hospital for 2-4 days after a C-section.
Complete recovery may take several weeks or longer, during which the
mother should gradually resume normal activities as recommended by her
healthcare provider.
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