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Caesarean section with pelvic presentation: planned and emergency caesarean section, preparation for surgery

Caesarean section – This is a surgical operation in which a child is born through an incision of the anterior abdominal wall and uterus. In antiquity, it was performed only on a deceased woman, to save her live child.

The operation technique improved, and with the arrival of antibiotics in obstetrics, complications began to occur less and less.

Why is a cesarean section performed more often today in the pelvic presentation of a fruit?

Pelvic presentation – This is when the baby lies in the uterus through the buttocks or legs. During natural childbirth, the buttocks or legs are the first to move along the birth canal, which are smaller in volume than the head, which leads to difficulties, which leads to adverse consequences for the baby.

Caesarean section with pelvic presentation: planned and emergency caesarean section, preparation for surgery

As traumatism of the spinal cord and brain, liver, spleen, suprarenal glands, brachial plexus, nodal muscle, hip joints. In women, uterine, cervical and vaginal tears are more common.

Therefore, if you are diagnosed with a pelvic presentation, 38 to 39 weeks will be sent to the pregnancy pathology department in accordance with the plan. They will carry out a complete examination and, finally, they will determine: natural birth or cesarean section.

Caesarean section with a pelvic presentation should be performed if:

  • the baby lies down with his legs (previous foot) or with his legs and buttocks at the same time, he bends down (previous mixed buttock). With the onset of labor and rupture of the amniotic fluid, the fetal stem or the umbilical cord may fall
  • Rear view (the child has its back against the posterior wall of the uterus), extension of the fetal head and inclined handles. In these cases, the delivery will be prolonged. After the birth of the buttocks, the head enters the pelvic cavity and the umbilical cord is held between the head and the bones of the pelvis. In this state, the child can not live more than 5 minutes.
  • Narrow pelvis and large fruit (with a pelvic presentation of large fruit is considered fruit of more than 3600 grams). Births through the birth canal are not possible, because pelvic size smaller than the size of the fetus
  • malformations of the uterus, such as the uterus of two antlers, the septum of the uterus, the myoma: for the birth of a child an obstacle may arise. During the myoma by caesarean section and the septum is likely to be removed.
  • The age of the woman of the first birth for more than 30 years or before pregnancy, the woman suffered from infertility. Here you can think about hormonal disorders. These women in labor may develop weakness in labor, which will require emergency surgery.
  • Premature birth of up to 37 weeks and fetal weight less than 2500 kg.
  • pregnancy postponed for more than 40 weeks
  • Chronic hypoxia of the fetus.

In these cases, the child does not have enough internal reserves to safely overcome the birth process:

  • is waiting for a child (the loss of the scrotum between the legs during labor causes irritation of the recipient and premature respiratory movements)
  • You have twins, and the first fruit in the pelvic presentation.

If you decide to give birth yourself, in childbirth, there may be situations that require an emergency cesarean section:

  • Water spilled before the cervix is ​​fully opened can cause loss of the umbilical cord or leg of the fetus.
  • Weakness of generic forces. Good fights are needed for a successful delivery in pelvic presentation.
  • fetal hypoxia
  • Prolapse of the umbilical cord.

However, caesarean section with a pelvic presentation also has its own complications:

  • Damage to the intestine, bladder, uterus, ovaries, fallopian tubes.
  • bleeding
  • an infection
  • Injury to the presentation part of the fetus.
  • thrombosis
  • abdominal adhesions
  • Trauma to the fetus due to difficulties to remove it.

A cesarean is contraindicated if the fetus is dead or if it has malformations that are incompatible with life, and if the patient has an infection.

The decision is made!

So, the tests are done, you accepted the operation.

Caesarean section with pelvic presentation: planned and emergency caesarean section, preparation for surgery

The anesthesiologist advises you: if there are no contraindications, you will be offered spinal anesthesia. This means that during the operation you will be aware and will be able to hear your child’s first crying and see it immediately after birth.

The day before surgery for lunch, eat soup and tea. The dinner is canceled. At night, take a hygienic shower, you can not sleep, you can take a sleeping pill.

In the morning, do a cleaning enema.

One hour before the operation, the midwife will perform the impairment: the injection will relieve anxiety, facilitate the introduction of anesthesia, turn it into sterile underwear, rinse the vagina and place the urinary catheter to control the amount and quality of urine during the operation.

The cesarean section lasts 40 to 50 minutes. The anterior abdominal wall is cut in the bikini area by a transverse incision of approximately 12 cm in length and sutured with a cosmetic suture, which is almost invisible after 6 months.

If you are conscious, in 3-5 minutes from the start of the operation you will be able to see your child. After a touching moment of going out with your baby, obstetricians-gynecologists will suture the uterus and stomach for about half an hour.

After surgery

Will be transferred to intensive care. The first two hours every 15 minutes, more rarely, you will see how the uterus contracts, the procedure is painful, but it is necessary to place a bottle of hot water with ice on the stomach.

Caesarean section with pelvic presentation: planned and emergency caesarean section, preparation for surgery

Every three hours the pressure, pulse and temperature will be measured. Be sure to prescribe an antibiotic, anesthetic, medications that accelerate the reduction of the uterus.

You can get up in 10-12 hours, the sooner you do this, the faster you will recover from the operation.

The first day of hunger, the second day you can eat chicken without fatty broth, still water, tea without sugar. You should start to discharge the gases and peristallize the intestines if you do not feel it, inform the doctor.

For 3-4 days there will be a chair. Until that time, you must follow a diet, eliminating the foods that cause the swelling of the intestine.

The child will be delivered as soon as he / she is transferred from the intensive care unit to the general ward, and will be able to get up.

All medications prescribed after a cesarean section are compatible with breastfeeding. If the doctor prescribes something else, you will be informed.

On the fifth day, the points will be removed. If you have no complications and everything is in order with the child, then, for 5 to 7 days, you will return home with your baby.

After a 2-month cesarean, a gentle regimen is necessary: ​​do not lift weights, do not live sexually, do not use saunas, swimming pool, gym, wash only under the shower.

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