Monday, March 19, 2012

Why do a cesarean section?

Cesarean section (sectio caesarea) is a surgical procedure that involves making the cut on the abdomen and the uterus and the birth of your baby through the incision. It can be planned, when known in advance that there is a failure of vaginal delivery or emergency, when the birth occurs because of complications which is too dangerous to complete the delivery vaginally.


The percentage of pregnant women who give birth by Caesarean section is about 20-25% of us, and grow over the years. Cesarean section is an operation that opens the abdominal cavity, and therefore as a way of delivery carries a greater risk to the pregnant woman by vaginal delivery, the greater the likelihood of infection, heavy bleeding, injury to internal organs, thromboembolism, and so on. It also remains longer in hospital than after vaginal delivery.

Why is the planned cesarean section?

Indications for elective Caesarean section are:

- A previous Caesarean section with a vertical incision of the uterus (called "classic" C-section), or two or more cesarean sections with a horizontal incision of the uterus. If you had a cesarean section, the following delivery may still be vaginal deliveries.

- Operation of the uterus (uterine surgery, partitions, etc.).

- Threesomes or more children in the womb.

- Makrozomija, or a big baby, combined with your small pelvis.

- Placenta previa or placenta prednjačeća.

- Pelvic presentation of the fetus (baby leads the pelvis or legs, not heads) in primiparous or oblique or transverse position of the fetus.

- State of the babies that can be exacerbated by vaginal delivery.

- Infection (HIV, HPV, genital herpes).
Why this is an emergency C-section?

- The cervix does not open, do not head down, in short, labor is progressing.

- Fetal heart tones indicate that the condition (state) such that the baby can no longer sustain the continuation of vaginal delivery.

- Umbilical Cord near the head slipped down into the vagina, which prevents adequate oxygen supply to the baby (umbilical cord prolapse).

- Premature placental abruption, which reduced the surface attached to the uterus reduces blood flow to the baby, and the occurrence of bleeding that threatened the balance of pregnant women.

- Other factors that prevent normal vaginal delivery.

What is the preparation for cesarean section?

Your doctor will be with you the first interview whether it is necessary to do a caesarean section, and why. You need to have all the necessary documents (ID card, health card, blood group and Rh factor, etc.), and laboratory preparation.

Examined by an internist you to determine whether your condition is such that you can apply an operation, and then you review an anesthesiologist with whom you can arrange any type of anesthesia you receive (general anesthesia, in which you sleep during surgery, or regional (epidural or spinal ) analgesia, where you are awake during the surgery. In the U.S., over 95% of Caesarean sections performed under regional anesthesia. Here the percentage is significantly smaller, but growing from year to year.

Pre opereacije, put the catheter in your bladder, you get anesthesia and surgery begins.

How to do a caesarean section?

There are several techniques that work cesarean section. Today, most operators is a horizontal incision in the skin (so-called "bikini" incision), while the longitudinal incision is only in extremely urgent cases, or cases where the expected complications. After cutting the skin, cut it in layers of tissue to the uterus, with a spacing of front abdominal muscles.

In the womb is a real low transverse incision, prokidaju ovojci fruit and extracted a child who is taught midwife and pediatrician. Immediately after treatment of the newborn and pediatric examinations, the women that a caesarean section under regional anesthesia for the child to show mom. For women, that cesarean section is under general anesthesia, the child process, review and refer to the department for infants.

Following removal of the placenta, review, and slowly closes the uterus, and anterior abdominal wall in layers.After the surgery, childbirth is moved to the intensive care unit.
Will I receive medication for pain after cesarean section?

Of course. If a caesarean section was done in the epidural or spinal analgesia, you will not feel pain the next 12 hours, because the anesthesiologist provides pain medication, but at the end of anesthesia. When you begin to feel that you can run your feet, you will be given some painkillers to cover the pain. If a caesarean section was performed under general anesthesia, at the end of anesthesia start to get pain medication for the next few days.
How is the recovery in the first few days after a cesarean section?

Immediately after anesthesia and in the next 24 hours you can feel the misery, discomfort, and may even occur, and vomiting. If this happens, your doctor will give you medication for such problems. The pain in the first 24 hours significantly more intense, so you'll definitely get painkillers. The next day, the pain is reduced to a tolerable measure, and without drugs, but you are looking for free if any pain medication.

The first day or two you are under intensive supervision, regularly controlled pressure and heart rate, such as stomach bleeding as much, will bring your baby to see, to get acquainted and to begin to breastfeed. You can breastfeed the side, so as not to jeopardize the wound in his stomach.

The wound was painful the first 24 hours, and then it turns into a feeling of uneasiness and tension. It is especially painful coughing or sneezing, but do not be afraid to be early "break" because you are nakašljati. It can not happen, but it is an unpleasant feeling, so when you cough or sneeze with his hands or a pillow place early press on the stomach to make it easier.

After 24 hours begin the first movement and slowly get up from bed, of course with the help of his sister. Hoses are lazy after surgery, so you'll feel the buildup of gases in the stomach, resulting in bloated belly. Your doctor will assess whether it is necessary to give drugs for enhancement of intestinal problems, or will pass spontaneously.

The first two days you have fluid replacement by infusion, followed by urinary catheter is removed, you start to urinate spontaneously and slowly bring food. First, juices, teas, then mushy food and biscuits, followed by a regular diet.

After 4-5 days you will be discharged from the hospital, and 7-10 days after surgery to remove the contact lenses. The first control is a gynecologist in a month.

In the event that after arriving home get a fever, redness and swelling starts early, show up any secretion of the wound or wounds discounts thread and starts to open, be sure to contact competent gynecologist.

The amount of vaginal bleeding is decreasing day by day. Vaginal discharge or lochia become clearer, you will move more freely, but do not be afraid to wear a belt to hold gtrbušnih muscle. There shall be regular lactation, breast-feeding your baby and enjoy it.
Will I be able to move when I come home after a cesarean section?

As much as it is important to rest after arriving home from the hospital, so it is important to regularly move.That should speed the healing of wounds, the overall recovery and prevents the formation of clots in blood vessels. Do not, however, exaggerate the movement, because the muscles are still weak and should be gradually getting used to the effort. Do not lift anything heavy, but your baby in the next 6 weeks. After reviewing the gynecologist for a month, you will be told that you can start with exercise and how intense. Also, as with vaginal birth, sex is not recommended during the first 6 weeks.

What is the scar after cesarean section?

Most common today is a horizontal incision ("bikini" incision) in the stomach when it comes to cesarean section.The first few days the cut is slightly above the skin, slightly darker in color than surrounding skin, there may be slight redness of the wound edges. Length of cut is usually up to 15 centimeters, but its setting is low above the pubic bone and below the underwear or bathing suit, so you will not see any on the beach.

During the first few months, scar fade, blend with the surrounding skin color, although some women may appear so called keloid or excessive scar development, when it is above the skin, rough, often painted darker.

What are my chances to give birth vaginally, if I had a previous cesarean section?

If you previously had a Caesarean section, it is likely that you can give birth vaginally in a subsequent pregnancy. Of course it depends on several factors, primarily made of why the first caesarean section. If, for example, had a first cesarean delivery as scheduled due to breech presentation, there is the option to birth vaginally.

However, if you first open enough, but three hours is not the baby down, and was well placed and you finally made a caesarean section for infants of 3000 g, then it is likely that you will now vaginal porođati very small. Of course the women with a caesarean section was done because of an underlying disease that exists now, in the second pregnancy, and this time will be performed caesarean sections.

In any case, the decision about whether you can go in vaginal birth after previous cesarean section brings your gynecologist.

It may be that you go to vaginal delivery, and to decide still end up giving birth by Caesarean section, although it is considered that about 60-80% of women who decided to try a vaginal birth after cesarean section, give birth vaginally.

Possible complications in this situation is the rupture of the uterus or spraying, which is very rare but extremely dangerous for both mother and baby.
How do I know if I can give birth vaginally after a cesarean section?

Some of the criteria for a vaginal birth after cesarean section:

- Previously had a cesarean, a lower transverse incision was made. If there were more cesarean sections, or one made with a "T" opening of the uterus, not trying to vaginal delivery.

- That there is no narrowing of the pelvis or its modified form.

- If not for the surgery on the uterus.

- If there is no disease or condition in which you increase the risk of vaginal delivery.

- If there are no conditions that now threaten your baby.
What are the benefits of vaginal birth after cesarean section?

First, avoid surgery, which itself carries a risk. Then, the risk of cesarean section as a way of delivery, where possible intense bleeding, and sometimes need a transfusion, a very rare woman in the surgery necessary to remove the uterus because of the complications that develop.

The risk of infection and the emergence of the same complications, longer hospital stay, recovery, more discomfort, are all reasons why you should think about a vaginal delivery, even if you previously had a Caesarean section. You should know that every cesarean section increases the risk of emergence prednjačeće placenta (placenta praevia) or ingrown placenta (placenta acreta), which can further complicate the delivery.
What are the risks of vaginal birth after previous cesarean section?

Even though there is no barrier to vaginal birth after birth, there is a risk (less than 1%) to reach the rupture, or spraying the uterus at the site of previous surgery scar. Such a life-threatening complications for you and your baby can lead to very heavy bleeding and lack of oxygen to the baby while still in your stomach.

It is considered that if a pregnant woman had a previous cesarean section, does not induce the birth, and should be very cautious with stimulation sintocinonom in vaginal delivery. Recent studies indicate that it is better to do a planned caesarean section for previous cesarean section, rather than wait to be pregnant izdilatira over 6-7 cm, and then go to an emergency cesarean section.
If I carry twins, do you have to go to the C-section?

A lot of factors affect the way of delivery in twin pregnancy. Primarily this affects the position and presentation of children in the womb.

First Approximately 40% of pregnant women with twin pregnancy, both children were placed head to the exit from the uterus. In such cases, most gynecologists would choose to go to vaginal delivery, of course, if there is no other reason that prevents vaginal delivery (large baby, a narrow pelvis, the uneven growth of children, etc.).

Second When the first baby (the one that is closer to the uterine output) set up the pelvis and the other head, it is planned caesarean section, due to the danger of mutual sticking the baby.

Third Both babies Breech presentation is a case to be solved individually by a gynecologist who takes delivery.

4th The first baby head and the other leg or pelvis, usually not a barrier to vaginal delivery.

Of course, if you wear more than two children, triplets or quadruplets, will certainly do a caesarean section.

You must know that there is a possibility that even though you first baby born vaginally, the other may require completion of cesarean section. It occurs more frequently in twin pregnancies where the baby is head first and the second is, if the second baby is placed transversely and can not give birth vaginally.
If I carry and give birth to twins vaginally, how is it different from my birth pregnant women giving birth to a baby?

Vaginal delivery of twin pregnancy carries certain risks that are higher than in singleton pregnancy. The greater the risk of prolapse, premature placental odlubljenja, especially after the release of the first baby, and more posleporođajnog bleeding.

When you are admitted to the maternity ward, an ultrasound will be done to determine the position of the twins.If both babies head will probably be recommended vaginal delivery. When the first baby (the one that is closer to the uterine output) set up the pelvis and the other head, it is planned caesarean section, due to the danger of mutual sticking the baby. Both babies Breech presentation is a case to be solved individually by a gynecologist who takes delivery. The first baby head and the other leg or pelvis, usually not a barrier to vaginal delivery.

If you're going to vaginal delivery, preparation for childbirth is no different from the preparation of pregnant women with singleton pregnancies (open history, enema, shower and room to bed). The contractions become stronger, and when the time comes for tension, you will be surrounded by a whole team of doctors and nurses who are ready for your delivery. The midwife, obstetrician, pediatrician, two (one for each baby), an anesthesiologist, pediatric nurses, now awaiting release of the first baby. After the first baby, your obstetrician reviewed to determine the position and prednjačeći of other babies. If you are the head or pelvis, the newt prokida other babies and moving birth of another child.

If the examination shows that other states across the baby, he decides to complete the delivery by Caesarean section. Birth of second twin usually occurs within minutes of the first, but it can tolerate up to half an hour. Of course, if monitoring of heart sounds to allow the second twin. If the obstetrician to assess heart sounds do not allow the second twin still waiting, it will perform an emergency Caesarean section.
How does a caesarean section in twin pregnancy?

Cesarean section is in essence no different in singleton and twin pregnancy. There is a large team of doctors and midwives, the acceptance of two children, but has remained largely the same.
How is the recovery after the birth of twins?

This depends on whether you have given birth vaginally or by caesarean section. It is common, however, for both modes of delivery to the newborn in twin pregnancy often smaller size, that is pregnant with twins often give birth before term, followed by immaturity of babies and their need for placement in intensive care, etc., making it more likely that will stay longer in hospital after the birth of twins.

The real difference was only after arriving home. Gather all the assistance available to you! Someone will have to be next to you at each feeding, dressing, bathing ... almost always!

But look at your baby when breastfeeding after a sweet fall asleep next to each other, will remove all doubts as to whether you are in life just to be necessary.

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