CESAREAN BIRTH Major fetal anomalies

Multigestation or conjoined twins

Is a delivery of the fetus through an abdominal incision into the uterus. Transverse fetal lie
Major concern in MCHN: ↑ incidence of CS

2 types of cesarean birth: Effects of Surgery on a Woman

 Scheduled  Stress Response

 Emergent  Interference with Body Defenses
 Interference with Circulatory Function
Indications for Cesarean Birth:  Interference with Body Organ Function
Maternal Factors  Interference with Self-Image or Self-Esteem

Preoperative Care Measures

✓Active genital herpes or HPV
✓AIDS or HIV-positive status  Informed Consent
✓CPD  Overall Hygiene
✓Severe hypertension  GIT preparation
✓Failure to progress in labor  Baseline I&O
✓Previous CS (classic incision)  Hydration
✓Elective  Patient’s chart & preoperative checklist
 Transport to surgery
Placental Factors
Intraoperative Care Measures
Placenta previa
Abruptio placenta  Administration of Anesthesia
Umbilical cord prolapse  Skin preparation (scrubbed w/ an antiseptic)
 Drape appropriately
Fetal Factors
Intraoperative Care Measures
Breech
Macrosomic fetus ✓Surgical incision Types:
Extremely LBW infant
Fetal distress • Classic Cesarean Incision
-made vertically  Risk for deficient fluid volume r/t blood loss during surgery
 Risk for deficient fluid volume r/t postsurgical fluid restriction
• Low Segment Incision
 Constipation r/t effects of abdominal surgery & anesthesia
-made horizontally
Discharge Planning
Intraoperative Care Measures
 Not to lift object heavier than 10lb
✓Birth of the baby  & walk upstairs > once a day for the first 2 weeks
 Recognize possible signs of
-once surgical incision is complete:
 infection
‣Retractors are slipped into the incision (spread incision apart)  Resuming coitus
 Future fertility (contraceptive)
‣Sterile towels are used  Return visit (2 weeks after)
‣Uterus is cut & child’s head is born Summary
‣Oxytocin is given
✓The term cesarean birth is preferred over CS or delivery.
‣Umbilical cord is cut
✓CB may be either a scheduled or an emergent procedure.
✓Birth of the baby
✓Preop./assessment measures before surgery
-after full birth:
✓The skin incision may be vertical or horizontal.
‣Uterus is pulled forward onto the abdomen
✓Make assessments to prevent postpartum and postsurgical
‣Incision closure complications
Intraoperative Care Measures ✓ “Once a cesarean, always a cesarean” is no longer true.
✓Introduction of the Newborn

‣The baby is shown to the mother

Postpartal Care Measures

 Pain r/t surgical incision