Caesarean section

1. Done by : Shaimaa abuali
C-section delivery

2. Definition of c-section delivery:
• A Cesarean section (C-section) is the surgical removal of the
baby from the abdomen. C-sections may be elective or required
due to emergency conditions such as pregnancy complications.

3. Indications for C-Section
Maternal considerations include the following:
• Maternal pelvis deformities or disproportions
• Previous C-section
• Previous surgery or injury in the pelvis, reproductive or rectal area
• Existing tumor or mass in the reproductive area
• Multiparity pregnancy

4. Uterine/anatomical considerations include the following:
Abnormal placenta (such as placenta previa, placenta
accreta)
Cervical issues
Prior classical hysterotomy (the surgical removal of the
uterine contents)

5. Fetal considerations include the following
• Irregular fetal heart rate
• Fetal distress
• Umbilical problems (such as cord prolapse)
• Malpresentation
• Large fetus (macrosomia)
• Congenital anomaly

6. Classification
• Category-1; required immediate delivery. Thread maternal or fetal life.
• Category-2; required urgent delivery. maternal or fetal compromise that is
NOT immediately life-threatening.
• Category-3; required early delivery. NO maternal or fetal compromise.
• Category -4 required elective delivery. At time suited to the women and
maternity staff.

16. Complications
Although C/S is relatively safe, the women need counseled about
potential complications.
• Case Fatality Rate for all C/S is 5 times that for vaginal delivery,
Although for elective C/S the difference does NOT reach statistical
significance.
• The risks associated with C/S, divided into:
1. Short-term complications.
2. Long-term complications (for future Pregnancies).
3. Neonatal complications

17. Long-term complication
1. Adhesion Formation:
- Resulting from cesarean delivery is common and significantly contributes
to the risk of complications at future deliveries (Ectopic pregnancy risk will
increase).
- Cause significant morbidity and mortality related to bowel obstruction,
infertility or organ injury during repeat abdominal surgery.
2. Uterine Rupture:
- The incidence of uterine rupture is higher in women who undergo a trial of
labor after cesarean delivery.

18. Abnormal placentation: placenta Previa, accre abruptio.
4. Infertility and Subfertility.
5. Scar complications:
- Long-term abdominal scar complications include numbness, pain
- Uterine scar complications include cesarean scar pregnancy and post-
menstrual spotting (an indentation on the endometrial side of the cesarean
scar).

19. 6. Thromboembolism:
- One of the leading causes of maternal mortality related to cesarean delivery is
deep vein thrombosis resulting in pulmonary embolism.
- The incidence of such complication can be reduced by adequate hydration,
early embolization and administration of prophylactic heparin.
7. Paralytic ileus:
- Expected in the first few days.
- Bowel sound are absent or hypoactive and there is NO passage of gas.

20. 7. Anesthesia complication:
- Abscess and Meningitis
- epidural hematoma
- Neurologic injury
- Respiratory arrest

21. Neonatal Complication
1. Respiratory Difficulties.
2. latrogenic injury.
3. Failure to Breast-feed.

23. PREOPERATIVE DIAGNOSTIC PROCEDURES
Preoperative assessment procedures for a woman who is to have a
cesarean birth include documentation of fetal status and presentation
and maturity by ultrasound assessment. In addition, assessments also
include circulatory and renal function and those for all pre surgery
patients, including:
Vital sign determination
Urinalysis
Allergy

24. • Complete blood count
• Coagulation profile (prothrombin time [PT], partial thromboplastin time
[PTT])
• Serum electrolytes and pH
• Blood typing and cross-matching
During pregnancy, for example, a woman (particularly one who was in
prolonged labor) can have an elevated leukocyte count (up to 20,000
cells/mm3), so this finding is not as helpful an indicator for the presence of
infection

25. nursing diagnoses and nursing care plans for cesarean
birth:
1. Deficient Knowledge
2. Acute Pain
3. Risk for Infection
4. Risk for Deficient Fluid Volume
5. Risk for Disturbed Maternal-Fetal Dyad
6. Risk for Injury
7. Anxiety or Fear
8. Risk for Situational Low Self-Esteem
9. Powerlessness
10.Risk for Ineffective Self Health Management
11.Risk for Impaired Parenting