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6. Caesarean Section
Hi friends so today we will be discussing caesarean section and it’s types , what do we mean by caesarean section ?
Cesarean section is the delivery of the fetus by the incision on the abdominal wall, which is laparotomy and then the incision on the uterine wall which is hysterectomy, so the incidence of the caesarean section is increasing and why is that? :
The first one is increased safety of the operation because caesarean section is much more safe in order to prevent various complications , the second one is detect high-risk pregnancy early , the third one is increased number of Nulliparous with age more than 30 years with medical complexions , and the last one is the primary cesarean section is more. So by monitoring all of these points we opt for cesarean section to prevent various complications in the pregnant women, the types of cesarean section it is divided into two types : lower segment cesarean section and classical upper segment Caesarean section.
What is lower segment cesarean section?
In lower segment cesarean section, the incision is given on the lower part of the uterus that is the incision would be horizontal where is in case of upper segment cesarean section, the incision is given on the upper part of the uterus that is the incision is given vertically , often at times the lower segment cesarean section is preferred over classical section, there are certain situations where we have to opt for classical section and let us know that why?
: The first one is dense additions due to Caesarean section , so what happens here is due to previous repetitive cesarean section the under net tissues tightly get adhered to the abdominal wall. So in order to opt for this upper segment caesarean section .
The second one is women suffering from cervical cancer or fibroids . So here we shouldn’t disturb the cancer cells underneath in order to prevent the situation to get more worsened .
The third one is complete anterior placental previa or morbid anterior placenta . If the placenta is deeply morbidly attached to anterior part of the uterine wall the chances of bleeding gets more high , so in order to prevent that we opt for this classical section.
Now let us come to the advantages of lower segment cesarean section over upper segment cesarean section or the classical section . So the first advantage is there would be less incisional bleeding , because the tissues are thin as compared to the upper segment and the muscle appositions are perfect, therefore, the healing would be better. There would be less wound dehiscence and the scars would rupture less. Now coming to the upper segment cesarean section, let us know its disadvantages over LSCS.
The first one is that the incisional bleeding would be more that we have discussed earlier , there would be imperfect muscle apposition and the healing would be less and there would be more wound dehiscence.
Now let us come to the indications of cesarean section:
The first one is antepartum hemorrhage which includes placenta previa and abruptio placenta, that means if the placenta gets separated, then we should opt for cesarean section to prevent complications. The second one is contracted pelvis or cephalopelvic disproportion. The third one is carcinoma of the cervix. The fourth one is vaginal obstruction which is also called stenosis , which means the vagina will obstruct the fetus in order to expel it out.
Now let us come to dystocia, which is also called abnormal labor, so dystocia is determined by three ps : which means power , passenger and passage.
Power would be weak uterine contraction .
Passenger would be large fetus
Passage would be small pelvis.
Further incidences are :
Non reassuring fetal heart rate , Fetal distress , Failed initiation of labor and hypertensive disorders like Eclampsia and pre-eclampsia. Last the medical disorders like diabetes and heart failure .
So this is what we have known about the basic concept of cesarean section see you in the next video. Thank you !
