CESAREAN SECTION (1): WHAT IS IT ? Mazé?
Dr Claude Allouche, gynecologist
Ahuza Clinic, Raanana
058 726 02 64
- Cesarean section - in Hebrew nitouah kesari (Cesarean section operation) - is a surgical procedure which consists of giving birth to a baby through an incision in the abdomen and uterus.
- An increasingly safe operation, it should in no case be considered as a trivial act.
- Having a cesarean section is a medical decision and presents certain risks which should not be neglected.
- This type of intervention is carried out when the conditions, in the mother or in the child, are not favorable to sleeping vaginally.
- Convenience cesarean section, that is to say carried out only at the request of the request without medical reason, will only be accepted after explanations of the risks linked to this procedure.
- Cesarean section is performed under epidural anesthesia (in Hebrew “epidural”) or spinal anesthesia so that the patient does not feel any pain during the surgical procedure.
- This type of anesthesia allows the patient to stay awake and witness the birth of her baby.
- This also prevents anesthetic products from passing through to the baby and causing them to fall asleep before birth.
- Rarely, in cases of extreme urgency or ineffectiveness of the epidural, general anesthesia may be necessary.
- Caesarean section can be planned or carried out in an emergency situation.
CESAREAN SECTION (2): ADVANTAGES AND DISADVANTAGES
- Cesarean section (in Hebrew nitouah kesari ( ניתוח קסרי)) is a surgical procedure which consists of giving birth to the baby through an incision in the abdomen and uterus.
- it has advantages, but also risks and disadvantages, which is why it is a medical decision during which the doctor and the patient evaluate the benefit/risk ratio of this surgical procedure.
- elective cesarean section, that is to say carried out only at the request of the patient without medical reason, will only be accepted after explanations of the risks linked to this procedure.
1/ Advantages:
- This is a simple, well-established surgical technique that allows childbirth to be completed quickly and the baby to be born in a few minutes.
- The duration of the procedure is on average 30 minutes, but may be longer depending on the history and potential complications.
2/ Risks and disadvantages
- Scheduled or emergency, cesarean section presents risks and/or disadvantages which must be taken into consideration:
A] For the future mother:
- complications related to surgery
* Hemorrhages
* adhesions
* infection
* wounds of neighboring organs (bladder, ureter, intestines)
* thromboembolic risks
* difficulties in resuming transit, occlusion
- complications linked to anesthesia, spinal anesthesia, epidural or general anesthesia
- increased risks for future pregnancies:
* uterine rupture,
* adhesions
* placenta implantation problem
- a slightly longer physical recovery
- a sometimes unsightly scar.
B] For the newborn:
- respiratory problems occur more frequently if the cesarean section is carried out before 38 weeks,
- the start of breastfeeding may be delayed.[
CESAREAN SECTION (3): SCHEDULED OR EMERGENCY? WHAT INDICATIONS?
- Caesarean section (in Hebrew nitouah kesari ניתוח קסרי) is a surgical procedure which consists of giving birth to the baby through an incision in the abdomen and uterus.
- It can be scheduled or carried out in an emergency situation.
1/ Scheduled cesarean section
- It is generally planned around 39 weeks of amenorrhea, before the start of labor and is not linked to an emergency situation.
- Most often, it is performed under spinal anesthesia.
The most common indications are:
- placenta previa, a case where the placenta totally or partially covers the cervix.
- a scarred uterus, i.e. a patient who has already had one or more cesarean sections previously
- a twin pregnancy: depending on the position of the babies, the existence of one or two pouches and the location of the placenta(s).
- breech presentation, preventing vaginal delivery.
- significant macrosomia, if the estimated fetal weight is greater than 4500g (or 4250g in the case of diabetes)
- a viral infection in the mother (active genital herpes, HIV): the aim of the cesarean section is to avoid contamination of the baby with the virus during a vaginal delivery.
2/ Emergency cesarean section
This is an unplanned cesarean section occurring before or during labor.
The most common indications are:
- fetal heart rate abnormalities
- Stagnation of cervical dilation
- Failure to engage the baby's head in the pelvis.
- Bleeding related to placenta previa or placental abruption
- pre-eclampsia,
The degree of urgency of the cesarean section and the speed with which it must be carried out depend on the indication given, the state of health of the future mother and that of the baby.