DELIVERY
CESAREAN SECTION
REVIEW
WHAT IS AN OPERATIVE
VAGINAL DELIVERY?
REFERS TO A DELIVERY IN WHICH THE OPERATOR USES
FORCEPS OR A VACUUM DEVICE TO EXTRACT THE
FOETUS FROM THE VAGINA, WITH OR WITHOUT THE
ASSISTANCE OF MATERNAL PUSHING
WHEN IS AN OPERATIVE VAGINAL DELIVERY
INDICATED?
PROTRACTED SECOND STAGE OF LABOUR
SUSPICION OF IMMEDIATE OR POTENTIAL FOETAL COMPROMISE
SHORTENING THE SECOND STAGE FOR MATERNAL BENEFIT
WHEN IS THE SECOND STAGE OF LABOUR
DESCRIBED AS PROTRACTED?
FOR NULLIPAROUS WOMEN, A PROTRACTED SECOND STAGE CAN BE DEFINED
AS NO PROGRESS (DESCENT, ROTATION) AFTER ABOUT 3 HOURS WITH
EPIDURAL ANESTHESIA AND ABOUT 2 HOURS WITHOUT EPIDURAL
ANEASTHESIA
CUP
SOFT VS RIGID
MUSHROOM VS BELL
WHAT CONTRAINDICATES AN OPERATIVE VAGINAL
DELIVERY?
EXTREME FOETAL PREMATURITY
FOETAL DEMINERALISING DISEASE
FOETAL BLEEDING DIATHESIS
UNENGAGED HEAD
UNKNOWN FOETAL POSITION
BROW OR FACE PRESENTATION
SUSPECTED CPD
WHEN SHOULD ATTEMPTS AT AN OPERATIVE
DELIVERY BE ABANDONED?
AFTER 3 PULLS/ATTEMPTS
WHAT ARE SOME COMPLICATIONS OF AN
OPERATIVE DELIVERY?
FOETAL
INTRACRANIAL HAEMORRHAGE
BRUISES
ABRASIONS
LACERATIONS
FACIAL NERVE PALSY
CEPHALOHEMATOMA
RETINAL HAEMORRHAGE
SUBGALEAL HAEMORRHAGE
SKULL FRACTURE
SHOULDER DYSTOCIA
MATERNAL
LOWER GENITAL TRACT LACERATIONS
VULVAR OR VAGINAL HEMATOMAS
URINARY TRACTINJURY/VOIDINGDYSFUNCTION (URINARY RETENTION OR
INCONTINENCE)
ANAL SPHINCTER INJURY
PAIN
HAEMORRHAGE
INFECTION
WHAT IS A CESAREAN SECTION?
A SURGICAL PROCEDURE IN WHICH INCISIONS ARE MADE THROUGH A
WOMAN'S ABDOMEN AND UTERUS TO EFFECT DELIVERY OF THE INFANT AND
PLACENTA.
HOW ARE CESAREAN SECTIONS CLASSIFIED?
BASED ON THE INCISION
LOWER SEGMENT
CLASSICAL
BASED ON THE INDICATION
MATERNAL VS FOETAL
EMERGENCY/CATEGORY 1
URGENCY/CATEGORY 2
SCHEDULED/CATEGORY 3
ELECTIVE/CATEGORY 4
NAME COMMON MATERNAL INDICATIONS FOR A
CESAREAN SECTION
PREVIOUS CLASSICAL CESAREAN SECTION
PREVIOUS LSCS X2
LSCS <18/12 TO 2 YEARS AGO
PREVIOUS MYOMECTOMY
PLACENTA PREVIA
LOWER SEGMENT UTERINE FIBROIDS
CPD
NAME COMMON FOETAL INDICATIONS FOR A
CESAREAN SECTION
FOETAL DISTRESS
MALPRESENTATION
ACTIVE HERPES INFECTION
MATERNAL HIV WITH A HIGH VIRAL LOAD
VASA PREVIA
NAME COMPLICATIONS OF CESAREAN DELIVERY
EARLY
INJURY TO SURROUNDING STRUCTURES
NEONATAL TRAUMA
HAEMORRHAGE
HYSTERECTOMY
INTERMEDIATE
VTE
PAIN
HAEMORRHAGE
INFECTION
WOUND
ENDOMETRITIS
LATE
PLACENTA PREVIA
MORBIDLY ADHERENT PLACENTA
BOWEL OBSTRUCTION
MENSTRUAL IRREGULARITIES
THE END