Caesarean section is Indications and contraindications, pros and cons

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Practically every family is looking forward to the birth of their own baby. A little more, and there will be an exciting meeting with a new person. Many women want to give birth to a child naturally, but this is not always possible according to indications. A caesarean section is another option for a speedy meeting with the baby. Surgery has its pros and cons, but usually everything ends well.

What is a caesarean section

Parental activity in women takes place individually. Some give birth naturally, while others need surgery. A caesarean section is a surgical procedure in which the baby is removed from the abdomen. This operation is very common in the modern world, about 40% of babies are born thanks to it.

Doctors and obstetricians studying in detail photos of caesarean section while studying in medical institutions. This allows them to better prepare for future operations. PracticalSkills are very important in the work of a doctor. Photos of caesarean sections in medical schools are necessarily discussed in lectures. Maternal and infant mortality has been markedly reduced since the birth procedure was introduced.

Sometimes a caesarean section is the only way to save both a woman and her baby. But, like any surgical intervention, this procedure has both advantages and disadvantages. Before starting a caesarean section, the anesthesiologist selects the optimal method of anesthesia. Each type of anesthesia has both pros and cons, so it is important for the doctor to assess all the risks for the woman in labor. After the introduction of anesthesia, the expectant mother falls asleep.

Caesarean section is an abdominal operation. The surgeon first cuts the skin, fat and related tissues. After the doctor dissects the uterus. The incision can be both vertical and horizontal, sometimes they can alternate. From a cosmetic point of view, a small transverse seam is considered optimal. The doctor sucks out the fetal fluid with special equipment and takes out the child, who then passes it to the nurse.

If anesthesia is used, in which the woman is conscious, then the baby is applied to her chest. After the child is wiped and weighed. Medical staff must evaluate the newborn on the Apgar scale. At this moment, the woman in labor is stitched. The whole operation, if it goes without complications, takes 30 to 45 minutes.

Who should not have a caesarean section?

Any operation can be dangerous forlife and he alth of the patient. A caesarean section is a procedure that cannot have absolute contraindications. Very often, there is a rather serious reason for the operation, for example, saving the life of a mother or a child. If the he alth of the woman in labor is at risk, then doctors most often perform surgery.

Can a caesarean section be done with a deep prematurity of the fetus? No, because it is a relative contraindication. In this case, doctors do their best to avoid premature birth and keep the pregnancy. If the fetus is not developed enough to live outside the uterus, then it is very rarely possible to save it.

Is it possible to have a caesarean section if the woman in labor has infectious inflammatory diseases of the gynecological profile? Undesirable, it threatens with purulent-septic complications. But if a woman has absolute indications for a caesarean section, then it is carried out. About 20-30 years ago, during such an operation, the uterus was immediately cut out from the woman in labor, which made it impossible for her to subsequently become pregnant again. Currently, all the efforts of doctors are aimed at preserving the organ. This is done through an operation called an extraperitoneal caesarean section, which temporarily seals off the abdomen.

Another relative contraindication is intrauterine fetal death. To preserve the he alth of the mother in this case, it is better to have a natural birth. Prolonged severe hypoxia is also a contraindication for caesarean section. Do not carry it out and with highly complicated natural childbirth. For example, in the caseif obstetric forceps were applied and an incision was made in the cervix, after which a balloon was inserted into it to enhance contractions.

Indications for surgery

Sometimes a woman has no choice, in which case she has to give birth only by caesarean section. In some situations, surgery can be avoided. Indications for caesarean section in the hospital can be both absolute and relative. In the second case, doctors will consider the need for surgery.

Can a caesarean section be replaced by natural childbirth? In some cases this is allowed. But only doctors can make a decision, they will take into account the risk to the he alth of both the mother and the child. Non-gynecological diseases of a woman are considered a relative indication for caesarean section. For example, with heart ailments, natural childbirth can be dangerous. In the process, the body of the expectant mother experiences tremendous overload, which can cause various seizures, an increase or decrease in pressure.

Often, doctors recommend a caesarean section for women with vascular, kidney, and nervous system diseases. Natural childbirth is undesirable for expectant mothers with myopia, as they can cause even more visual impairment. For women with diabetes, doctors recommend a caesarean section. Cancer of any kind is a relative contraindication to both natural childbirth and pregnancy in general.

Very often, cesarean section is recommended for nulliparous women over the age of 30, as they are more likely to experience complications. Natural childbirth is undesirable in the presence of such a dangerous disease as gestosis of pregnant women. The surgical procedure is most often performed on ladies who already have a scar on the uterus from previous operations. Relative indications for cesarean section include a clinically narrow pelvis and weakness of labor, which is not corrected by drugs.

Absolute indications for surgery

Sometimes, even before the process begins, it is clear that a woman will not be able to give birth naturally. In this case, indications for caesarean section are absolute. In some situations, a woman cannot give birth on her own, as this threatens the life of the expectant mother and the fetus. Then the doctor decides on the optimal way out of the situation, which is what a caesarean section is in this situation.

Absolutely narrow pelvis is one of the indications for surgery. In this case, the child cannot physically pass through the birth canal. There are several degrees of narrowing of the pelvic bones, for example, with type 3-4, resolution from the burden is possible only by caesarean section through the abdominal cavity. Also, a lot here depends on the size and weight of the child. With a narrowing of the pelvic bones of the 1st-2nd degree, natural childbirth is possible, but sometimes in their process, the doctor may decide to perform an emergency caesarean section.

Women who have ever gone through any kind of uterine surgery should understand that there is a possibility of uterine rupture during childbirth. If the sutures are inconsistent or not much time has passed since the intervention, then the doctors directexpectant mother for a caesarean section. The scar is examined both before and during childbirth, as the situation may change. If a woman has already undergone 2-3 caesarean sections, then such an indication is considered absolute.

Surgery is recommended if there are mechanical obstacles to natural childbirth. Absolute indications include ovarian tumors, some types of uterine fibroids, deformity of the pelvic bones. Sometimes the placenta attached in the wrong way can block the exit to the birth canal. A caesarean section is performed with the transverse position of the fetus or with prolapse of the umbilical cord due to polyhydramnios. If placental abruption occurs before or during childbirth, then the woman is operated on. If this is not done, the expectant mother may bleed to death.

For what indications is the operation carried out urgently?

Caesarean section is most often carried out as planned. If a woman has absolute indications, then on the appointed day she comes to the hospital, where she is operated on. If the contractions begin ahead of time, then the procedure is carried out on an emergency basis. If the pregnancy goes well, then the doctor appoints a caesarean section and it is done on time.

One of the indications for emergency intervention is weak labor activity or its absence. If the drugs that the doctors gave to the patient did not have the necessary effect, then there is only one way out. A woman in this situation is shown an emergency caesarean section. The patient's uterus is cut open and the baby is taken out, which saves his life. With a long anhydrous period in childbirth, the baby often has hypoxia,this case goes for minutes.

Another indication for an emergency caesarean section is sudden heavy bleeding. Every minute is also important here, and the birth process can prevent doctors from providing the patient with all the help necessary in this case. Doctors remove the baby from the uterus and transport the woman to the intensive care unit after a caesarean section. How long will she stay there? This is a very individual setting.

If a woman in labor has a second caesarean section, then in the process of childbirth, her scar may begin to diverge. Of course, before the start of contractions, doctors repeatedly check the consistency of the suture, but sometimes everything happens unexpectedly. During childbirth, all organs of a woman are overloaded, but especially the uterus. If the scar disperses, then the expectant mother may die. In this case, doctors perform an emergency caesarean section.

Number of surgeries a woman can have in her lifetime

Many girls dream of a big family, where children's laughter will constantly sound. But some of them think that this is not possible after a caesarean section. How many surgeries can be performed on a woman without much harm to her he alth? The opinions of doctors here differ.

A woman should understand that the second caesarean section and subsequent ones are most often more dangerous than the first because of the scar on the uterus. After the operation, its walls are damaged. Scar tissue has low elasticity, so it cannot fully stretch during subsequent pregnancies. It is especially dangerous if the break between them was small. The scar mustheal completely after caesarean section through the abdominal cavity. How long should I wait before planning a new pregnancy? Doctors say at least 3 years.

Anesthesia also does not pass without consequences, this also limits the number of operations. Russian doctors talk about 3, maximum 5 caesarean sections, depending on the woman's he alth. It should be taken into account the fact that with age, the muscles of the uterus weaken, it scars worse and takes longer to recover. With each subsequent operation, the risk of fistulas and immune failure increases.

Some doctors believe that as many caesarean sections can be done as a woman needs. Some of their foreign colleagues are of the same opinion. But here much depends on how the past surgical interventions were carried out. Modern experience allows more caesarean sections to be performed on a woman with less harm to her he alth than 10-20 years ago.

Which anesthesia is better to use?

Any abdominal operations are performed under anesthesia. If it is not done, then the patient will simply die from pain shock. A caesarean section uses either general anesthesia or one of two types of anesthesia: spinal or epidural. The method of anesthesia is chosen by the anesthesiologist, it depends on the state of he alth of the woman. Sometimes doctors combine anesthesia with each other, that is, they do spinal epidural anesthesia.

General anesthesia is now used less frequently than a few years ago. This is due to the fact that after it there are more complications than, for example, from spinal anesthesia. Induring the duration of anesthesia, it is more difficult for doctors to intubate. The risks from its use during pregnancy increase many times over. During general anesthesia, gastric contents may be inhaled into the airways, sometimes resulting in severe pneumonia. At the time of the operation, the harmful effects extend to both the expectant mother and the child. After a caesarean section, the baby may experience breathing problems. That is why obstetrician-gynecologists are now trying not to use general anesthesia.

But sometimes its use is necessary according to indications. General anesthesia is always used if the umbilical cord has prolapsed or the fetus is lying across. In some patients, the use of spinal or epidural anesthesia is not possible due to the presence of a contraindication to them. An emergency caesarean section is also often performed under general anesthesia, as in this situation minutes can count. Epidural or spinal anesthesia is not indicated if the mother has profuse bleeding.

Benefits for Mom

The biggest benefit of a caesarean section is that it saves the life of the mother and her baby. Not always a child can be born naturally, in this case, doctors come to the rescue. No pain of a caesarean section will overshadow the joy of meeting mother and baby.

Also, the operation is much faster than natural childbirth. How long does a caesarean section take? A little over half an hour. The operation helps to avoid long-term pain. This is another plus of a caesarean section. The procedure is notaffects the genitals, and they remain in the same state. This has a positive effect on the intimate life of a woman, because she will not have any seams or tears there.

Natural childbirth in some cases leads to hemorrhoids and prolapse of the pelvic organs. With a caesarean section, the patient may not worry about these troubles. Also excluded are ruptures of the cervix, which occasionally, but still occur during natural childbirth. Some women may develop incontinence due to prolapse of the pelvic organs, and the bladder in particular.

Another of the positive aspects of caesarean section is the absence of painful contractions and attempts. Yes, after the operation, the woman experiences pain, but it is incomparable with many hours of exhausting muscle contractions that are needed for the natural expulsion of the fetus. Some women in labor agree with the doctor for a caesarean section for money, as they are very afraid of discomfort.

Cons for Mom

In addition to the undeniable advantages of caesarean section, there are also disadvantages. If after natural childbirth, which went well, a woman soon forgets about the pain experienced, then after the operation, a scar remains forever. The scar will become less noticeable over time, but it will not completely disappear. If the doctor made a cosmetic suture, then it is usually thin and light. Sometimes, because of a scar after a caesarean section, a woman begins to feel ugly and inferior. Some moms even stop going to the beaches and going on vacation.

After natural childbirth, a woman who went through pain and anguish for herchild, immediately falls in love with him. After a caesarean section, mommy may feel strange psychologically. The story of the birth of the baby seems to her unsaid. Sometimes women do not perceive a newborn as their child at all. Or the mother is overcome with guilt towards the baby, it may seem to her that she did not try hard enough for his birth.

After a caesarean section, the duration of the discharge is the same as after a natural birth. For a long time, any load will be prohibited for a woman, it will be more difficult for her to take care of the baby. After a cesarean section, the stomach takes a very long time to take shape, it will be difficult to return it to its prenatal appearance. Hard training is needed, but they are contraindicated during this period. It is better for a young mother to listen to the recommendations of doctors. For at least a month after a caesarean section, a woman will not be allowed to lift anything heavier than her baby.

Benefits for baby

The main advantage of the operation for the baby is his birth. Sometimes a caesarean section is the only way a woman can give birth. Therefore, without surgical intervention, the baby would simply die. Even if a child is born prematurely, a month after a caesarean section, he almost catches up with his peers.

Babies born by caesarean section may be fearful. A mother must help her child. You need to lay the baby on your stomach more often, letting him know that he is safe. Another plus is the exclusion of birth injuries after caesarean section. What other benefits does itgives? The baby has a reduced risk of infection. This is especially important if the mother suffers from any contagious disease, such as the human immunodeficiency virus.

During natural childbirth, the baby may experience hypoxia. If the process is greatly delayed, then the baby may be born with various abnormalities. Sometimes even the death of a newborn occurs due to severe intrauterine hypoxia. If the child was born during a planned caesarean section, then he is insured against these problems. The baby is born on time and is not stressed.

Cons for a child

In natural childbirth, a baby goes through a difficult path in order to be born. But it is so conceived by nature, in which nothing happens just like that. A child born by caesarean section through an opening in the abdominal cavity does not experience these overloads. It would seem that this is a plus, but, unfortunately, everything is not so.

C-section baby is born too soon. During natural childbirth, a child passing through the paths gradually adapts to new conditions for him. There are changes in his circulatory and respiratory systems. If in the womb a child accidentally swallowed fetal water, which is quite common, then during the passage of the birth canal they are eliminated. With a caesarean section, this does not happen, which is fraught with the development of inflammation. Wet lungs can even make it difficult for babies to take their first breath.

During caesarean section, anesthesia affects not only the mother's body, the baby tooget some of the medicine. This can negatively affect him later, since anesthesia can hardly be called useful. C-section babies almost always score lower on the Apgar score than babies born vaginally.

In the first months of life, such newborns are more susceptible to disease. They may be less active than naturally born babies. Babies born by caesarean section usually have lower immunity at the beginning of their life, but here everything is in the hands of the mother. If a woman organizes impeccable care for her child, then he will soon catch up with his peers.

Possible Complications

Caesarean section is an abdominal operation that can be dangerous in some cases. One of the most common complications is a large loss of blood. This can threaten both the life of the woman in labor and her child. With a caesarean section, a woman loses an average of 3-4 times more blood than with a natural process. Sometimes a woman in labor needs a transfusion, which also carries risks.

After a caesarean section, many women have another complication - adhesions. This is the name of the films that form inside the small pelvis. Their large number interferes with the normal functioning of internal organs. In addition, adhesions in the pelvis can cause infertility. If the work of the intestines is disrupted, then the woman is waiting for constant constipation and even obstruction. In severe cases, doctors perform laparoscopy to get rid of adhesions. But this is an operation that carries he alth risks. Moreover, laparoscopyis a panacea for adhesions, after which they most often reappear.

Endometritis often occurs after caesarean section, as pathogenic microorganisms enter the uterine cavity. The disease may be asymptomatic for some time. Then the woman periodically begins to experience pain in the lower abdomen. She may be feverish, she experiences weakness and chills. The woman's pulse quickens, tachycardia occurs. Uncharacteristic discharge from the genital tract may appear, sometimes they contain impurities of pus. Doctors recommend visiting your gynecologist no later than a week after discharge from the hospital.

Complications after caesarean section may be related to the scar. If the blood vessels are not sutured enough, hematomas often form. They also occur with inaccurate treatment of the scar. The seams can become inflamed, it is easy to understand by swollen and reddened skin. If the process managed to go far, then purulent outflows appear. In difficult cases, due to inflammation, a woman may have a fever. In some cases, fever and even delirium occur. For treatment, the doctor prescribes a course of antibiotics to the patient. If a woman does not pay attention to the seam, then this may lead to a second operation.

The scar sometimes diverges, and this does not always happen in the first couple of days after the operation. The patient must comply with all the doctor's instructions and not lift weights. In some cases, over time, ligature fistulas form near the seam. They occur due to an allergy to the threads located inside the abdominal cavity. Also, ligature fistulas are formed when it enters the woundinfections. This complication does not occur immediately, it can appear several years after a caesarean section.

If a longitudinal suture was used during the operation, a hernia may form. This complication is quite rare and mainly in those who do not comply with the time periods recommended by doctors between caesarean sections. For example, a woman who becomes pregnant and gives birth every year for several years has a markedly increased chance of getting a postpartum hernia.

Complications of caesarean section are often caused by anesthesia. During the introduction of the tracheal tube, the throat is sometimes scratched. A woman may experience complications from the heart, sometimes there is a violation of the functions of the vessels. Severe consequences are caused by the penetration of the contents of the stomach into the respiratory system. A woman can be haunted by pain in the throat and back for a long time. Complications are possible in the form of ruptured veins, puncture of the spinal cord during epidural anesthesia.

After the completion of childbirth, a woman's uterus contracts naturally. With a gross intervention in the natural process, complications can begin. Sometimes there is atony of the uterus, that is, it becomes unable to contract. This can cause prolonged and profuse bleeding. Fortunately, this complication is quite rare today.

Expert Opinion

Doctors use caesarean section at a time when there is simply no other way out to resolve the burden. After the operation, the main task of the woman is as soon as possible.recover. This is necessary for both herself and her child.

After arriving from the hospital, a woman should explain to her family that in a few weeks she will need their help. At first, when doing household chores, a young mother should not bend over. It will be good if the father takes care of the main part of the bathing and dressing of the baby.

Mommy should try to establish breastfeeding, unless the doctor has recommended otherwise. Because of the drugs prescribed in the maternity hospital, they are often forced to give formula to babies. You can use the services of breastfeeding specialists, which are available at most antenatal clinics, they will help restore lactation.