Caesarean section

Cesarean section, C-section, or Cesarean birth

is the surgical delivery of a baby through a cut (incision) made in
the mother's abdomen and uterus. Healthcare providers use it
when they believe it's safer for the mother, the baby, or both..
 2 types of caesarean section

► There are two types of caesarean section, which differ according to

the direction of the incision on the abdomen. These are the classical
cut and the bikini cut. The bikini cut is more popular because it heals
and looks better, and causes less pain after surgery
Types of caesarean section
INCISIONS
 INDICATIONS FOR C-SECTION
► Labor fails to progress
► Compressed umbilical cord Umbilical cord compression happens when the umbilical
cord, the tube-like structure that connects the placenta to the fetus, becomes
compressed or flattened, restricting the flow of blood, oxygen, and nutrients to the
baby.
► Abnormal fetal heart rate
► Pregnancy of multiples
► Placenta previa (the placenta lies over the cervix)
► Placenta accrete (the placenta grows too deeply into the uterine wall)
► A fetus that is too big to be born vaginally
► A fetus in an unfavorable position (breech or transverse lie)
► HIV infection
► Active herpes infection
► Diabetes
► High blood pressure / Incompatible Pelvic outlet…( PELVIMETRY)
 PELVIMETRY
► Pelvimetry assesses the size of a woman's pelvis aiming to predict whether she will be
able to give birth vaginally or not. This can be done by clinical examination, or by
conventional X‐rays, computerised tomography (CT) scanning, or magnetic resonance
imaging (MRI).
► TYPES OF PELVIC OUTLET
The shape of the female pelvis has been divided into four classes by Caldwell and
Moloy, who report the following proportions on a population of 147 cases: gynoid, 41.4%;
android, 32.5%; anthropoid, 23.5%, and platypelloid, 2.6%.
 RISK OF C-SECTION
FOR THE MOTHER
► Infection
► Blood loss
► Blood clots A blood clot, also called a thrombus, is blood that has coagulated
or clotted.
► Injury to bowel or bladder
► Amniotic fluid embolism can cause potentially life-threatening breathing and heart
issues, as well as uncontrolled bleeding. It is an often fatal emergency that requires
immediate medical care for both the pregnant person and the baby.
► Reaction to anesthesia
► Amniotic fluid embolism is a rare but serious condition that occurs when amniotic fluid —
the fluid that surrounds a baby in the uterus during pregnancy — or fetal material, such
as fetal cells, enters the mother's bloodstream.
 RISK OF C-SECTION
FOR THE BABY
► Altered immune development
► Increased likelihood of developing allergies and asthma
► Reduced gut microbiome diversity -The gut flora (also referred to as the microbiome,
microbiota, or microflora) make up a world of microorganisms that populate our
gastrointestinal tract. It is estimated there are about 100 trillion of these microorganisms,
called microbes.
 NURSING RESPONSIBILITIES BEFORE
C-SECTION
► Signing of consent for the procedure( minor age are not allowed to sign)
► Placing an IV line
► Washing the surgical site (abdomen)
► Placing a catheter in the urethra, the tube that allows urine to pass out of the body
► In addition, an anesthesiologist will administer anesthesia. Sometimes in an
emergency, general anesthesia is used. Most of the time, however, an epidural or spinal
block is preferred. This type of regional block allows the parent to be awake and alert for
the birth of their baby.
► Removing nail polish from the finger and toe nails
 TYPES OF ANESTHESIA
► Types of Anesthesia
► There are two main types of anesthesia typically used: regional anesthesia, which makes
an area of your body numb, like a spinal block, combined spinal-epidural anesthesia
(CSE) or epidural anesthesia; and general anesthesia, where you go to "sleep" for the
surgery.
► The regional anesthesias, like an epidural, will block pain sensation in your abdomen and
nearby parts.3 You will be wide awake during the surgery and aware of everything.
► You will feel pushing, pulling and tugging, but not pain. One of the regional anesthesia
choices is the most common type of anesthesia for an elective cesarean section. 4
► Additional medications can be given if you are experiencing nausea, anxiety, etc.
► General anesthesia is used when your medical history or an emergency dictates that
regional anesthesia is too risky or not possible
 Signs of Recovery from General
Anesthesia
► Improve level of consciousness…
► Movement of extremities..
► Return of Bowel function / Peristalsis / Flatus / Eructation
► Stable Vital signs
► Return of sensation / sensitivity

► Eructation is the medical term for belching, burping, or passing gas through the
mouth. Gas pain is often referred to as bloating.
 Signs and Symptoms to watch out for after c-section

► Severe pain
► Heavy vaginal bleeding
► Redness, swelling, or excessive pain at the incision site
► Discharge from incision
► Cough or trouble breathing
► Swelling in your lower leg
► Pain while urinating or difficulty holding urine
► Fever
 Nursing interventions
► Application of Scultetus Binder per Doctor orders
► Nursing interventions include monitoring vital signs, airway patency, and neurologic status
► Managing pain
► Assessing the surgical site ( WATCH OUT FOR SIGNS OF INFECTION, WOUND DEHISCENCE,
WOUND EVISCERATION
► Assessing and maintaining fluid and electrolyte balance
► Providing a thorough report of the patient's status to the receiving nurse on the unit, as
well as the patient's family.
► Wound dehiscence is a condition where a cut made during a surgical procedure
separates or ruptures after it has been stitched back together.
► Evisceration is a rare but severe surgical complication where the surgical incision opens
(dehiscence) and the abdominal organs then protrude or come out of the
incision (evisceration). Evisceration is an emergency and should be treated as such.
Scultetus Binder
 Signs of Wound infection
► Symptoms of Wound Infections
► Pus. Pus or cloudy fluid is draining from the wound.
► Pimple. A pimple or yellow crust has formed on the wound.
► Soft Scab. The scab has increased in size.
► Red Area. Increasing redness occurs around the wound.
► More Pain. ...
► More Swelling. ...
► Swollen Node.
► Presence of foul odor..
► Fever