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
[Link] 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
