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Cesarean Section
Objectives
• Assess the anatomy, physiology, and
pathophysiology of the Cesarean Section.
• Analyze the diagnostic and surgical interventions
for a patient undergoing a Cesarean Section.
• Plan the intraoperative course for a patient
undergoing Cesarean Section.
• Assemble supplies, equipment, and
instrumentation needed for the procedure.
Objectives
• Choose the appropriate patient position
• Identify the incision used for the procedure
• Analyze the procedural steps for Cesarean
Section.
• Describe the care of the specimen
• Discuss the postoperative considerations for a
patient undergoing Cesarean Section .
Terms and Definitions
• Obstetrics
• See Indications
• Same as for L & D Terms STST p. 486
Definition/Purpose of Procedure
• Surgical delivery of an infant through the abdominal and
uterine wall. Often performed as an emergency for
abruptio placentae, placenta previa, or cephalopelvic
disproportion. May be scheduled for “previous c-section.”
• Performed when safe vaginal delivery is questionable or
immediate delivery is crucial because the well-being of the
mother or fetus is threatened
Indications
a. Abnormal presentations (breech, transverse, etc.)
b. Abruptio Placenta
c. Carcinoma of the Cervix
d. Cephalopelvic Disporportion (CPD)
e. Cervix will not dilate
f. Fetal distress** Most common reason
g. Habitual death of the fetus during the course of labor
h. Placenta Previa
i. Preeclamptic toxemia in pts where difficult labor is anticipated
j. Presence of STDs such as genital herpes
k. Previous cesarean section
l. Prolapse of the umbilical cord
Relevant A & P
• Physiology of pregnancy
• Female anatomy (covered last week)
Blood supply to internal
reproductive organs
Blood supply to vagina, ovary, uterus,
& fallopian tube
Pelvic Bones
Midsagittal view in supine position
with some ligaments
Pathophysiology
• Dependent on type of Indication
Female Pelvis: True Pelvis
• Final closing
– Sponges
– Sharps & sm items
– Instruments
Dressing, Casting, Immobilizers, Etc.
Procedure 15-1
Delivery Presentation
Labor & Delivery Terminology
• Stage one: onset of labor
• Stage two: complete dilatation of cervix
• Stage three: birth of the infant
• Stage four: after placenta is delivered
What is an episiotomy?
• First degree
• Second degree
• Third degree
• Fourth degree
Episiotomies:
Midline & Rt Mediolateral