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    Nandita Jali
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    1. This document discusses cesarean section, including definitions, types, indications, timing, benefits and risks, and postoperative care. 2. It covers lower segment and classical cesarean sections, absolute and relative indications for lower segment cesarean, and the preferred Pfannenstiel skin incision approach. 3. Preoperative, operative, and postoperative steps are outlined, along with immediate and remote maternal and fetal complications.

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    Obstetrics surgery

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    1. This document discusses cesarean section, including definitions, types, indications, timing, benefits and risks, and postoperative care. 2. It covers lower segment and classical cesarean sections, absolute and relative indications for lower segment cesarean, and the preferred Pfannenstiel skin incision approach. 3. Preoperative, operative, and postoperative steps are outlined, along with immediate and remote maternal and fetal complications.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    5 views9 pages

    LSCS

    Uploaded by

    Nandita Jali
    1. This document discusses cesarean section, including definitions, types, indications, timing, benefits and risks, and postoperative care. 2. It covers lower segment and classical cesarean sections, absolute and relative indications for lower segment cesarean, and the preferred Pfannenstiel skin incision approach. 3. Preoperative, operative, and postoperative steps are outlined, along with immediate and remote maternal and fetal complications.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 9

    Definition Nomenclature

    Incidence Factors section


    forrisingc
    Types differentincisions

    Indications each
    of
    5 Timing
    ofoperation
    6 NICEcategory

    7 Benefits Risks Cesarean


    of
    8 classical vs LSCS

    9
    Why Pfannenstiel ispreferred

    10 Pre
    op
    11 Procedure

    12 Post
    opcare
    13 complications

    1 Definition

    Anoperativeprocedure todeliver the fetusafter28weeksofgestationthrough


    an incision through abdominal wall uterus

    Lex cesarea

    2 Incidence 10151 optimum Robson'sclassification

    FactorsResponsible

    i Identification high risk pregnancy


    of
    ii Identificationofhigh risk fetus

    electronic
    iii use
    of fetalmonitoring diagnosis offetaldistress
    iv incidence maternalmedicalcomplic GDM PIH 35yearsage
    of
    v incidence
    of operativevaginaldelivery
    vi incidence
    of assisteddelivery
    Vii Fear case
    of medicoligal

    3
    Types
    Lowersegment CS classical Cs

    not commonlypractised in modernobs

    onlyindications
    Kerr Uterusadherent tobladder

    ii Morbidlyadherentplacenta previa
    iii Severlycontractedpelvis

    Ms iv Pretermdelivery is not formed

    adf.IE ii v cervicalca pelvic tumor


    I Schroeder
    g vi transverse lie

    1
    Sanger
    Inverted
    4 Indications ofLSCS

    Absolute common

    1 contractedPelvis 1 Fetaldistress
    2 CPD 2 Failed induction
    3 Pelvicmass fibroid 3 Dystocia non
    progressivelabor
    4 Advanced Cacomin 4 Malpresentation Malposition

    Vaginalobstruct atresia
    5 stenosis 5 Obstructed labor

    6 3
    previous LSCS
    6 Elective
    7 Previous classical CS
    8 Dead Fetus

    Relative
    1 APH

    2 Malpresentation

    3 Bad obstetric history Recurrentpregnancyloss

    4 Hypertensivedisorders

    5 Medical Condn_ HeartdisordersGDM

    5 Timingofoperation
    sweekpriortodate
    whtwain confinement

    Elective is
    uncertain Ratio I waittillspontaneous
    Maturity
    onset labor thenCS
    of
    6 NICE category

    category 2 immediatethreatto M F within30mins

    decision todeliverytime

    category 2 M Fcompromise noimmediatethreat

    D Dtime 75 mins

    Category 3 No M Fcompromise needsearlydelivery

    Planned to suiteveryone 39weeks


    Category 4

    if before administer steroids

    7 Benefits Risk Cesarean section


    of

    IncreasedRisk in subsequentpregnancies
    of complications
    1 Abortion 6 Uterinerupture

    2 Ectopic Adhesions
    pregnancy 7 PPH
    3 Pretermdelivery irritateduterus

    4 Morbidly Adherentplacenta
    5 Placentaprevia
    8 Classical vs lower segment c section

    9 Pfannested skin incisionpreferred


    1 Cosmeticvalue Disadvantages

    2 incisionalhernia i longertime

    3 wounddehiscence 2 Bloodloss

    4 Post more 3 unsuitableforclassicalsection


    opcomfort
    5 Fundus can be palpated

    6 MIDLINESKIN INCISION
    interference i respiration
    i Quickentry
    Stronger ii Moreexposure
    iii Bleeding
    iv Nervedamage
    10 Pre
    op
    1 Informedconsent

    2 NBM

    3 PPI H2blocker overnight I hr beforesurgery

    4 Foley'scatheter

    5 Antibiotics 1hrbefo
    Cefazolin2mg IV singledose Penicillin Clindamycin Gentamycin

    6 Abd scrubbed i soap

    7 Check FHS neonatologist

    8 Blood cross check

    9 IV cannula RL NS

    Operative

    1 AntisepticPainting 7.5.1 Povidone Iodine

    draping

    2 Anaesthesia
    Spinal Tq
    General LSCS
    Emergency

    PIH Preeclampsia
    S IntracardiacShunt
    HOCM
    EjectionFraction
    PulmonaryHTN
    OPERATIVE STEPS
    Oxytocin LOU 0.2mg Methergine
    1
    afterdelivery
    2 Delayed cordclamping
    3 Removal
    ofplacenta by controlledcordtraction

    12 Post care
    op
    1 Observation check vitals 6 8here
    2 IV
    fluids
    3 Oxytocin 5 IV
    Oxytocin
    4 Analgesics Pethidine
    5 Antibiotics

    6 Breastfeeding 3.4 his later

    7 Mother D1 Electrolyte fluid


    D2
    lightsoliddiet
    D5 Remove sutures

    Discharge

    13 Complications

    Maternal

    Immediate Remote

    1 PPH 1 Scarrupture futurepregnancy

    2 Shock 2 Incisional hernia


    3 Anaesthetichazards 3 CPP menstrualdisturbance
    hypotension aspin 4 Intestinalobstruct d t adhesions

    4 Infection endomyometritis

    Stitontis Fetal
    SSI
    1 Iatrogenicprematurity
    5 ParalyticIleus
    2 RDS
    6
    Injurytothebladder 3 Accidentalscalpel
    injury
    7 woundhematoma

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