Emergency cesarean forced surgery. Elective caesarean section

According to statistics, today every 3-4 pregnancy ends with an operation. The newly born mom will have to face not only the postpartum period, but also the state after the operation.

And this is twice as complicated. Responsibilities for the care of the baby has not been canceled. No one except you can attach the child to the breast. Not for nothing women are interested in how to get back to their former form as quickly as possible.

How to recover from cesarean section?

The change in your body begins immediately after the child is removed, still on the operating table. The uterus responds to a decrease in volume and decreases sharply. Thereby contributing to stop the bleeding.

From now on, it will decrease in volume every day. Completely reduced by about 2 months. After the operation, an ice pack is placed on your stomach - this is also a means for an improved reduction of the uterus and to stop the bleeding. Be sure to appoint uterine-reducing injections.

Postoperative scars on the uterus, anterior abdominal wall and skin will make themselves felt almost immediately. Especially severe pain in the first 3 days. Pain contributes to the release of stress hormones: adrenaline and norepinephrine, which adversely affects the state of the body, as well as the healing of scars and pelvic organs.

In addition, the tone of the muscles of the anterior abdominal wall is reduced to protect the cut abdomen. This may lead to hernia formation in the future. You must prescribe painkillers.

A cesarean suture will be treated daily. Removed for 7-8 days.

Doctors will tell and show, and only you can help yourself.

14 ways to recover faster after a cesarean

1.​  After the operation, do not lie down!  After surgery 10-12 hours, and if you had a spinal anesthesia, then a day, you will have to maintain bed rest. The first time you need to rise in the presence of physicians. The sooner you get up, the better for you.

2.Physical activity  Almost immediately after surgery, you need to move, turn in bed. The seam is firmly sewn with thread, it will not disperse. 3-4 hours after cesarean you need to perform the first exercises. Bend and unbend the legs in the ankle and knee joints, hands.

3. Perform breathing exercises.

• Lying on your back, take your hand to the side - inhale, return to the SP - exhale.
• Lying on your back, legs stretched out and arms along the body. Raise straight arms up - inhale through the nose, lower arms down - exhale through the mouth.
• Lying on the left side, left hand under the head, right - along the body, legs straight. Raise your right hand up, touch the pillow, - inhale, lower - exhale. Repeat 1-2 times. Repeat too on the right side.
• Lying on his back, legs extended, his right hand is on his stomach, his left hand - on his chest. Inhaling through the nose - inflating the abdomen, exhaling through the mouth - deflating.

After you are able to climb, for 2 days begin to perform the exercises sitting on the edge of the bed, your legs are lowered.

• Flexion, extension of the legs at the knee joints.
• Inhale - pull the knees up to the chest, helping with the hands, exhale, return to the SP
• Inhale - spread your arms to the sides, exhale - draw in the stomach and return to the SP

From 3-4 days:

• Lying on his back, bent at the knees, arms along the body. Lift the pelvis and turn it to the right - left, lower it.
• We lie on your back, knees bent, arms outstretched. Knees lowered to the right, outstretched arms - to the left, knees down to the left, extended arms - to the right.
• We lie on our backs, legs and arms are extended, lift one leg and begin to draw numbers from 1 to 6. Then the same with the other leg. Every day we add 1 digit and reach 20.
• To return the muscle tone of the perineum, there is a complex of Kegel exercises.

If you do gymnastics, then recovery after cesarean will go much faster. There will be no adhesions, the elasticity of the tummy will return with time, the uterus will be reduced in a short time. But first you should consult with your doctor.

Against the background of temperature, if there was a large blood loss during the operation, if you have thrombophlebitis, exercise is contraindicated. Do not perform gymnastics through force. Stop exercising if pain occurs.

Caesarean section is not compatible with intense physical exertion. It is impossible to lift weights, swing a press, train on simulators, run, squat for the first 2-3 months.

Important!  You should also remember that excessive exercise will not contribute to the production of milk. Therefore, it is contraindicated for lactating mothers.

3.​ Lactation.  Breastfeed baby. What will it give? During nipple sucking in the body, oxytocin is produced. It stimulates milk production in the mammary glands and reduction of smooth muscles, i.e. uterus.

In addition, it is a love hormone that helps the formation of maternal instincts. And they say a lot about the beneficial properties of breast milk for a child and everyone knows that there is nothing better.

4.​  Anemia.  The need for iron during pregnancy and breastfeeding is always increased. With caesarean section, blood loss is several times higher than after natural childbirth.

After surgery, you may develop anemia. This disrupts the healing of tissues, the contraction of the uterus and is not the best effect on the state of health. If the doctor says that your hemoglobin is lowered, you need to take iron supplements.

5.​ Lie on your stomach.  Already on the second day after cesarean, you can go to the stomach. This will accelerate the contraction of the uterus.

The first day after surgery will have to endure a urinary catheter. This is not pleasant and makes movement difficult. It is put before surgery, to control the amount and color of urine, as well as to prevent injury to the bladder during surgery.

After surgery, they also consider how much urine was excreted per day. It is important to assess whether there was damage to the bladder or ureters. An empty bladder is an important condition for the correct contraction of the uterus, and you will not be able to get up on the vessel for the first 12-24 hours.

After surgery, you may experience constipation. This is due to reduced intestinal tone, hormonal load, and of course, an inactive lifestyle. If there is no chair by the third or fourth day, you will be given an enema.

Drink more water, move more. At home it is worth eating more vegetables and fruits, dairy products, soups and cereals with buckwheat and pearl barley, vegetable oils.

7.​ Nutrition.  The body needs strength to return to normal after surgery, as well as for feeding the child. Therefore, eat more meat, protein is a building material, and you have scars that need to heal.

More fiber: vegetables and fruits, but exclude overseas fruits. Remember that you will breastfeed your baby. Therefore, your menu should not harm the baby. You can not eat food with preservatives, spices, hot sauces, smoked meats, grilled chicken, move dogs, pizza, fatty and fried. Food should be stewed, boiled and steamed.

8.​ I will recover with massage and self-massage.  It improves skin tone, improves blood circulation and metabolism. Muscle tone is also increasing.

Interesting!  In addition, the massage has a positive effect on the nervous system. Normalizes sleep, reduces pain sensitivity. You can perform self-massage.

In the technique there are 4 methods: stroking, rubbing, kneading and vibration.

Already from the first hours you can stroke the stomach with a palm in a circle, from top to bottom and bottom to top.

You can use a tennis ball. Write them in a circular motion clockwise starting from the navel.

Perform a massage with a contrast shower.

9.​ Wear a bandage.  It will ease the pain, support the weakened abdominals. The bandage is especially indispensable in the first days and weeks. In the prone position, the bandage is not needed only when moving. Do not wear a bandage for more than 3 hours. From 4-6 weeks the bandage is not needed, and its long wearing can lead to the opposite effect, i.e. loosen the press.

10.​ Hygiene.  Unfortunately, if you had a caesarean section, then you will be allowed to take a shower only after they have removed the suture and then provided that it has healed well. It will happen in about a week.

Before this, it is necessary to wash parts in order not to wet the seam. Be sure to observe intimate hygiene: wash with soap and water after each use of the toilet.

11.​ Watch for secretions.

• In the first 3 days they are bright red and very abundant.
• From 4 to 10 day pink-brown e or brown. Every day their number decreases, and the color becomes lighter.
• By day 10 yellowish or white smear.
• By week 3 contain streaks of mucus.
• Fully discharge will stop by 6-8 weeks.

If they are very abundant, dirty color and with an unpleasant smell, while you are worried about pain in the lower abdomen or fever, you should consult a doctor. There may be complications that will slow the recovery of the body after childbirth and the healing of the uterine scar.

12.​  Sleep.The body should rest well. Sleep in the afternoon, with the child.

13.​ Properly care for the scar on the skin.  Stitches will be removed for 6-7 days. If there are no complications, take a shower at home every day, but do not rub the suture area with a washcloth. After a shower, treat it with green paint, unless the doctor prescribes anything else upon discharge.

In order not to leave a rough scar, after a month, you can use special ointments (contraktubeks, solcoseryl, klirvin), if you wish, you can contact the beauty salon.

Important!  If there is pain, swelling and discharge of pus in the area of ​​the suture, you should consult a doctor.

14.​ Walking through the fresh air.Rapid wound healing and tissue nutrition is impossible without oxygen. In addition, it will be useful to your baby.

After 6-12 months, scars will heal, muscle and skin tone will return.

Tidying up your body after childbirth and cesarean is not so easy, but the joy of the birth of your crumbs will overshadow all the difficulties.

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Childbirth is a process to which the woman’s body is fully adapted. But sometimes, for one reason or another, natural childbirth can be a danger to the health or even the life of both the child and the mother. In such cases, operative delivery is performed - a cesarean section.

Caesarean section may be planned  and urgent. Planned cesarean section is appointed during pregnancy: according to indications or at will of future mother. The decision on urgent cesarean section is taken if complications arise already during labor or dangerous situations that require urgent intervention (acute fetal hypoxia, placental abruption, etc.).

Indications for cesarean section are divided into absolute  and relative. Absolute are those on the basis of which the doctor unconditionally designates the operation, and natural childbirth is out of the question. These indications include the following.

Narrow pelvis of the woman in labor. Because of this anatomical feature, a woman simply cannot give birth on her own, as there will be problems with the child's passage through the birth canal. This feature is detected immediately upon registration, and the woman from the very beginning prepares and adjusts for operative delivery;

Mechanical obstacle, not giving the fetus to pass naturally. It may be:

• defragmentation of the pelvic bones;
• ovarian tumors;
• placenta previa (placenta is not where it should be, blocking the fetus way out into the cervix);
• individual cases of uterine fibroids.

Probability of uterine rupture. This indication for cesarean section takes place if there are any stitches and scars on the uterus, for example, after previous cesarean section and abdominal operations.

To testimony threatening the child's health  include various genital infections of the mother, as the child may become infected, passing through the birth canal.

As for the urgent cesarean section, it is prescribed in the event that the labor activity is very weak or stopped altogether.

How is the cesarean section, what happens before and after

1. How long do a planned cesarean section? The date of the operation is set individually and depends on the state of the woman and the child. If there are no special indications, then a cesarean section is prescribed on the day nearest to the expected date of birth. It also happens that the operation is carried out with the start of contractions.

2. Preparation.  Usually, a future mother who is awaiting a planned cesarean section is placed in the maternity hospital in advance in order to conduct an examination - to determine that the baby is full and ready for birth, and to monitor the condition of the woman. As a rule, a cesarean section is scheduled for the morning, and the last meal and drink is possible no later than 18 hours the night before. The stomach of the operated patient must be empty in order to prevent its contents from entering the respiratory tract. In the morning, on the day of the operation, hygiene procedures are carried out: they do an enema, shave pubis. Then the woman changes into a shirt, and she is taken away or taken on a gurney to the operating room.

Immediately before the operation, anesthesia is performed, a catheter is inserted into the bladder (it will be removed a couple of hours after the operation), the stomach is treated with a disinfectant. Further, in a woman’s chest, a small screen is installed so that she cannot see the progress of the operation.

3. Anesthesia.  Two types of anesthesia are available today: epidural and general anesthesia. Anesthesia involves the introduction of a thin tube through a needle at the exit of the nerve roots of the spinal cord. It sounds pretty scary, but in reality the woman is experiencing discomfort for only a few seconds when she is punctured. Further, she no longer feels pain and tactile sensations in the lower body.

General anesthesia.  This type of anesthesia is used in emergency cases when there is no time to wait for the effects of epidural anesthesia. First, a preparation of the so-called pre-anesthesia is administered intravenously, then a mixture of anesthetic gas and oxygen is administered through the tube in the trachea, and the last is a preparation relaxing the muscles.

4. Operation. After the anesthesia has worked, the operation begins. How to do a cesarean section? First, make a cut on the abdominal wall. During the operation, there are 2 possible types of incisions: longitudinal (vertical from the womb to the navel; this is done in an emergency, because it is faster to reach the baby through it) and transverse (above the womb). Next, the surgeon moves apart the muscles, makes an incision in the uterus and opens the fetal bladder. After removing the baby, the placenta is removed. Then, the doctor first sews the uterus with threads that dissolve after a few months - after the tissues have grown together, and then the abdominal wall. A sterile dressing is applied, ice is put on the stomach so that the uterus is intensively reduced, and also in order to reduce blood loss.

Usually, the operation takes from 20 to 40 minutes, while the child is taken to the light already in 10 minutes, or even earlier.

5. The postoperative period.  A day after the cesarean section, the woman is in the intensive care unit or intensive care unit so that doctors can observe her condition. Then the new mother is transferred to a regular ward. To reduce the pain she is assigned painkillers,  drugs to reduce the uterus and the normalization of the gastrointestinal tract. Antibiotics are sometimes prescribed, but this is done individually. Gradually, the doses of drugs are reduced, and they are completely abandoned.

If the operation went without complications, get up for the first time  a woman is allowed after at least 6 hours. First you need to sit on the couch, and then stand for a bit. In no case can not strain, to experience at least minimal exercise, as it threatens the divergence of the seams.

It is highly desirable to purchase in advance postoperative bandage, wearing it will greatly facilitate movement and discomfort in the first days after a cesarean section, especially when you need to lie down or get out of bed.

On the first day after the operation, it is recommended to drink only water without gas, and you will need to drink a lot to compensate for the loss of fluid. You will also need to empty your bladder in time. It is believed that a full bladder prevents the contraction of the uterus.

On the second day, allow liquid food (cereals, broths, etc.). If everything is in order, then from the third for after the operation, you can return to the normal diet recommended by lactating women, but after birth, many mothers complain of constipation, and in order to alleviate the situation, it is advisable not to eat solid food for several days.

Also, this problem is solved with enemas, candles (candles with glycerin are usually used; when you put such a candle, try to lie down for a while) and eating foods that have a laxative effect (kefir, dried fruits, etc.).

7. After discharge from the hospital.  The first month and a half after the operation of cesarean section you will not be able to take a bath, swim in the pool and ponds, you can only wash in the shower.

Active physical exercise  need to postpone for at least two months. At this time, need the help of relatives and husband. Although it is impossible to completely abandon physical activity. Ideally, the doctor after surgery should tell you about the exercises that will speed up the recovery of the body, at least you can ask about it yourself.

Renew sex life  recommended no earlier than six weeks after surgery. Be sure to take care of contraception. Experts advise you to plan the next pregnancy only after 2 years, during which time the body will fully recover and will be able to ensure the full development of the future baby.

Are natural births possible after cesarean?

Contrary to popular belief, a woman can give birth to a child herself if the previous pregnancy ended with a cesarean section. If the stitches healed, there were no complications, the reproductive system was successfully restored and there is no indication for another cesarean section.

Pros and cons of cesarean section

Prompt delivery is possible both for medical reasons and for the woman’s own will. However, doctors usually oppose such a decision, discouraging the future mom from surgery. If you are also considering the possibility of an operation, provided that normal delivery is not contraindicated to you, carefully weigh all the positive and negative aspects of the issue.

Cesarean section

• during surgery, injuries to the genitals, such as tears and cuts, are impossible;
• delivery by caesarean section takes a maximum of 40 minutes, while during natural childbirth a woman often has to endure contractions for several hours.

Cons caesarean section

• psychological aspect: moms complain that at first they don’t feel connected with the child, they don’t have the feeling that they gave birth to him;
• limitation of physical activity and pain at the suture site;
• scar. Read more about this in the article.

Consequences of a cesarean section

The consequences can be divided into 2 types: for mother  due to surgery, and for a child, due to unnatural birth.

Implications for mom:

• pain in the seams, followed by a scar on the abdomen;
• restrictions on physical activity, the inability to take a bath and recover intimate relationships for several months;
• psychological state.

Implications for the child:

• psychological; there is an opinion that children who were born by surgery, adapt worse to the outside world. It is worth noting that the opinions of scientists on this issue are different, and the experience of mothers shows that in most cases the fears about the lagging of children in mental development are contrived, and they are not worried about this. However, it is impossible to deny the fact that the child does not go the way prepared by nature, and helps to prepare for a new environment of existence;
• the possibility of residual amniotic fluid in the lungs of the newborn;
• getting into the child's blood anesthesia drugs Read more about the effects of cesarean section and watch the video in

Complications after cesarean section

Complications after anesthesia.  If you are going to have a cesarean section using epidural anesthesia, you need to remember the following point. After the operation, the catheter with the anesthetic for a while is left in the back, and drugs for anesthetizing the sutures are injected through it. Therefore, after the operation is completed, the woman may not feel both or one leg, and is unable to move.

There are cases when, when putting a woman on a couch, the legs turn up, and since the operated patient feels nothing, this fact can go unnoticed for a long time.

What does it threaten with? Due to finding the limb in an unnatural position develops prolonged positional compression syndrome. In other words, soft tissue for a long time are without blood supply. After neutralization of compression, shock, severe edema, impaired motor activity of the limb develops and, not always, but quite often, renal failure, all this is accompanied by severe pain that lasts for several months.

Be sure to ask the hospital staff to check whether you were laid on the couch. Remember that sometimes crushing syndrome is fatal.

In addition, anesthesia is often accompanied by headaches and back pain.

Complications after cesarean section

One of the most common complications is spikes. Loops of the intestine or other organs of the abdominal cavity grow together. Treatment depends on the individual characteristics of the woman: the case may be limited to normal physiotherapy or go to the need for surgical intervention.

Endometritis  - inflammatory process in the uterus. To prevent it and prescribe a course of antibiotics immediately after surgery.

Bleeding  also refer to complications after cesarean section and, in rare cases, lead to the need to remove the uterus.

Complications may arise during the process. healing sutures, up to their discrepancy.

So, cesarean section is a guarantee of life for mother and child in cases where natural childbirth is impossible or dangerous. Every year this operation is improved, and the number of complications decreases. However, the human factor cannot be excluded, therefore, if you know about the main features of the operation and postoperative care, this will help you to avoid complications and enjoy the joys of motherhood without any grief.

Video of how a cesarean section passes

Answer

So, we have already discussed in general issues related to the operation of cesarean section and its methods, technique and possible difficulties in the process. We talked about the types of cesarean section, such as emergency surgery or planned cesarean section. Now let's take a closer look at the nuances of each type of cesarean section and the indications for their implementation.

Emergency surgery - cesarean section.
By performing an operation on emergency caesarean section, the child is born into situations in situations where the birth process cannot be completed quickly through the birth canal so as not to cause significant harm to the mother’s health or to the health and life of the fetus. If we talk about mommy, then from her side the indications for conducting an emergency operation will be those cases where, due to the development of certain diseases, the further course of labor will pose a threat to her health and sometimes her life. On the part of the fetus, such indications for carrying out an emergency operation will be considered cases when the course of a further labor act will be an unbearable burden for it, which can lead to the formation of birth injuries or a birth of a child in a state of acute asphyxiation (development of acute oxygen deficiency). Such situations are possible in the following cases.

Formation of pathology - clinically narrow pelvis.
  In such cases, pregnancy was determined quite normal pelvic size, which is quite possible to give birth. But at the time of birth, the situation has changed and it turned out that in the internal dimensions of the woman's pelvis simply does not match the size of the fetal head. This happens with a large fetus, a state of prolonged pregnancy and some other situations. Usually this situation becomes clear in the process of the onset of labor, when contractions can go on already actively and for a long time, and disclosure in the area of ​​the cervix has already occurred almost completely. In this case, the head, in spite of the presence of active labor and already beginning attempts, is not moving towards the exit from the birth canal. Usually this is formed in such cases when the head of the fetus is too large in size relative to the internal bony size of the mommy's pelvis.

This may be due to the anatomical contraction of the pelvis or the abnormal shape of the inner bone ring in the pelvis. The same can be formed in the presence of a large-sized fetus, when its head simply cannot be configured. At the same time, the bones of the child’s skull do not have the ability to enter each other’s stitches in the area of ​​the stitches, as can occur under normal conditions at birth. Usually, the cause of this condition of the head is prolonged pregnancy. Also, this happens in cases where the head of the fetus will be inserted into the pelvic cavity is not the smallest size. This can occur when the head is extended to approach the pelvic bone ring, for example, in such a situation when the fetus is not the nape of the neck, as it should be in most cases, but the face or frontal part of the fetus. If you suspect the presence of a clinical narrow pelvis, a woman’s condition can be monitored for an hour - if the baby’s head stands and does not advance along the birth canal, an operation is performed - an emergency caesarean section.

Problems in childbirth.
  Indications for emergency caesarean section may be premature discharge of amniotic fluid with no effects from labor-stimulating therapy. Normally, the amniotic fluid must be poured towards the end of the first stage of labor. In other words, the water must flow to the end of contractions when the cervix is ​​already opening. In cases where the amniotic fluid is poured before the formation of contractions, doctors put the state of premature rupture of the amniotic fluid. And further in this situation, events can take place in several different scenarios. Immediately after the rupture of the amniotic fluid occurs, regular labor can start, and then everything goes completely normal and the birth proceeds as usual. But maybe this is an option when the waters are gone, and the contractions do not start at all and the generic process does not move.

Then the doctors decide on the use of methods of artificial excitation of labor. To this end, a woman is given a drip and intravenous drugs of prostaglandins and oxytocin are injected. These substances contribute to the beginning and continuation of labor. Such actions will be urgently needed for the reason that since the opening of the membranes of child, the baby will no longer be protected from penetrating to it various infections through the mother's vagina, he will not be protected from the external environment by the fetal membranes and cannot be inside the uterus after the discharge of water more 12-24 hours. It will be fraught with him for the formation of various kinds of inflammatory or infectious complications, and they will also be highly likely for the mother for the same reasons. If, as a result of all activities for labor induction and under the influence of the drugs used, labor activity does not start, a decision is made to conduct an emergency cesarean section.

Anomalies of labor.
  Sometimes the causes for emergency cesarean section can be various anomalies during labor, which are in no way amenable to medical correction and treatment. Usually these conditions include the weakness of labor. With such a state, labor activity is there, contractions are underway, but they are insufficient in strength, while the contractions themselves are not long and do not lead to the opening of the cervix and the advance of the tribal process to its final. The main reasons that can lead to a weak labor activity are anxiety and negative, sharply negative emotions in relation to childbirth, excessive psychological stress of the expectant mother. Disorders in the function of the endocrine glands or organs of the reproductive system can also affect the birth process.

The presence of pathological changes inside the uterus in the form of endometritis - inflammation of the uterus that occurred in the past, as well as the presence of a defective scar on the uterus, uterine fibroids or malformations of the development. The overstretching of the walls of the uterus as a result of carrying several fruits, large fruit, or high hydration may have a negative effect on the generic process. Anomalies of labor can also occur with a congenital state of decreased excitability of the muscle fibers in the uterus or for some other reason.

For the purpose of correcting or treating a condition of weakness of labor activity, medications are used that are administered intravenously in an IV drip. Usually it is prostaglandins and oxytocin. When prescribing these drugs, the doctors after a certain period of time conduct an inspection of the woman and observe how rapidly the cervix is ​​opened. If the uterus and its fibers do not react in any way to the drugs administered to the woman, then it is decided that labor induction and stimulation are ineffective. In such cases, it is also necessary to make a decision about operative delivery by performing an emergency cesarean section.

Problems in the state of the fetus.
  One of the main indications for the use of emergency caesarean section in childbirth is the threat of acute hypoxia of the fetus. In the process of childbirth, the state of the fetus will be observed as closely as the state of the woman in labor is observed. The condition of the fetus and how it feels, you can be judged on the basis of several indicators. First of all, it is the heartbeat of the fetus, determined in childbirth. Under normal conditions, the heart rate of the fetus is about 140-150 beats per minute, and for the time of labor it can increase to 160-180 beats. This is a normal reaction to contraction and changes in blood circulation in the walls of the uterus and the placenta. The fetal heart rate during childbirth is recorded using a special apparatus (cardiac monitor) and fixed on a special tape. Also, the fetus's heartbeat during labor and delivery can be determined by the doctor with a special obstetric stethoscope. Deviation of heart rate from the norm may indicate the fact that the child does not have enough oxygen.

Tomorrow we will continue the discussion of the operation of emergency caesarean section.

Forced surgery

And sometimes during childbirth the life of a mother and child can depend on the speed of the decision to conduct an emergency cesarean section. Such an operation is used if births cannot take place in a natural way without harming the mother and her child.

Basic indications for emergency measures

It often happens that neither the doctors nor the woman herself before birth give no reason for the operation. A woman can go to the maternity ward with fairly intense contractions, confident that labor will start from minute to minute. But if the cervix does not open for a long time, it is necessary to make a decision about the operation. This is the most common example.

Also, unforeseen help of physicians is needed if:

• Incipient uterine rupture

It can only be determined directly during childbirth. If the woman in labor has already given birth with a caesarean section, a rupture occurs along the scar left after the previous operation. Uterine rupture can also be triggered by prolonged labor or a mismatch between the size of the baby’s head and the pelvic woman.

• Premature placental abruption

Unfortunately, this can happen at any stage of pregnancy and even with the absolute health of a woman. With such a diagnosis, the prognosis is always very serious both for the fetus and for the woman herself. In such a situation, the speed of deciding on an emergency operation is extremely important.

• Acute fetal hypoxia

In simple terms, there is a lack of oxygen. Most often, the problem occurs directly during childbirth. As a rule, due to the fact that the umbilical cord as the birth advances is tightened around the child in a knot.

• Umbilical cord prolapse

Quite often, this situation occurs when pelvic presentation of the fetus. Further independent childbirth is very dangerous, so under similar circumstances, emergency cesarean is most often done.

• The transverse position of the fetus

If the baby is located across the uterus, it cannot exit. Sometimes it happens that the waters are poured out, and the child remains in this position and cannot roll over, because there is no water anymore. The only way to save a child in such circumstances is surgery. The transverse position of the fetus is also found in repeated delivery, when the uterus is too stretched and the baby is in an unstable position. As a rule, the prognosis of such an outcome can be made at the stage of pregnancy, and the woman is proposed to give birth using a planned cesarean section.

• Clinically narrow pelvis

The pelvis in its size may not be narrow at all, but already during the birth it may become clear that it is small for passing the baby. This situation can also happen if the fetus size was “underestimated” by ultrasound.

Who decides on the operation

The situation should be assessed by an obstetrician-gynecologist: how is the process going on, is the fetus's health suffering, is it advisable to continue natural childbirth. The doctor voices her reasons for the woman in labor and she can either agree to an emergency cesarean section or refuse. The final decision always remains with the woman.. If she is conscious, she needs to sign a consent. If the patient is against the operation, it is necessary to sign a waiver, in which she confirms that she assumes responsibility for the life and health of the child.

Options for anesthesia for caesarean section

If, during labor, a catheter was inserted into the space above the dura mater, epidural anesthesia can be used for emergency surgery, which occurs within 15-30 minutes. In this case, the woman is conscious.

If there is no catheter, and ongoing contractions prevent an accurate puncture for epidural anesthesia, general anesthesia is used.

In emergency caesarean, spinal anesthesia is also used, for which it is necessary to give an injection to the lumbar region. The effect of anesthesia begins after 5 minutes, so it is possible to quickly begin the operation.

Features of the procedure

Unlike a planned operation, when in most cases a transverse incision is made in the lower abdomen, with emergency caesarean section possible longitudinal section  from the pubis to the navel, providing full access to the pelvic and abdominal organs.

Sometimes during emergency blood transfusions may be requiredbecause the woman in labor loses a large amount of it.

If the woman in labor is conscious, the newborn is shown to her immediately, after which he is taken to the ward for observation by a pediatric neonatologist.

The whole operation takes about 40 minutes., and on the very extraction of the child takes about 10 minutes at the beginning of the operation.

Emergency cesarean section is a method of saving the life of mother and fetus. Exposure is carried out with the wrong course of natural labor. The operation is carried out after various activities that have not yielded a positive effect. The patient cannot know whether such an intervention will be carried out in advance. In most cases, the decision is made by a specialist when there is a threat to the life of the child.

Emergency surgery is carried out in the process of natural childbirth. In many cases, the doctor and patient are not aware of possible complications.

A specialist should warn a woman that natural childbirth does not always proceed smoothly. Sometimes there are problems. To minimize the negative consequences for the health of the child, the woman is sent for urgent surgical intervention. The following indications for emergency caesarean section are highlighted:

• absolute reasons;
• relative factors.

Both groups can be established during pregnancy. If a woman has a history of a variety of chronic ailments, the doctor warns of possible surgical intervention. Sometimes problems are found during labor. In this case, the patient is transferred from the birth chamber to the operating room. Before this, the doctor explains what the consequences may be the further independent actions of the woman. To understand the reasons for the operation, it is necessary to disassemble them separately.

Absolute reasons

There is a weight of indications to planned cesarean section. Emergency surgery in many women is administered suddenly. But sometimes the doctor discusses possible surgical intervention before the onset of labor. If a woman decides to give birth independently, it is necessary to provide all the conditions for a quick transfer of the process to the operating room.

Absolute causes are various pathologies in the state of a woman. For many patients, surgery is recommended due to problems with the divergence of the pelvic bones. Normally, the pelvis moves apart as the delivery approaches. This is necessary to move the baby to the lower part of the uterus. The shift occurs due to the separation of the bones and the work of the hormone-oxytocin. The upper part of the uterus begins to contract. The pressure on the fetus increases. Gradually, the child moves down. If the pelvic bones do not move apart the child maintains the position. The action of the hormone causes the uterus to contract. There comes a natural labor activity. Under pressure, the fluid in the lungs of a child begins to be gradually excreted. The fetus opens pulmonary respiration. Lack of oxygen leads to hypoxia. The baby starts to choke. To quickly give the fetus access to the air, it is necessary to carry out surgery.

Recommended caesarean section and with a large weight of the fetus. The body weight of the child is normal should not exceed 3.5 kg. But many mothers do everything to ensure that the child quickly gains body weight before giving birth. The error occurs due to the characteristics of fetal development. Until the seventh month, the formation of limbs and various systems in the fetus. From the eighth month, the formed child begins to actively gain mass. Pregnant women continue to eat during this period as usual. The amount of nutrients supplied to the fetus exceeds the norm. The child becomes large. If the ultrasound diagnosis of the estimated weight of the fetus exceeds 4 kg, the doctor offers surgery. Some women think they can cope on their own. This leads to an emergency cesarean section.

The operation is carried out due to the weak movement of the child through the birth canal. The fetus lacks oxygen. To save the life of the child will only emergency intervention by doctors.

Additional reasons

Emergency cesarean section is appointed and with a sudden discharge of amniotic fluid. The water may suddenly drain due to the low location of the placenta. This pathology is often established in the process of planned ultrasound in the early stages of pregnancy. To increase the gestation period, a pessary is installed in a woman. It does not allow the cervix to open up prematurely.

But sometimes a woman notices a drop of liquid in her underwear. You can set the nature of the liquid yourself. For this purpose, tests for leakage of water are used. If testing has shown a positive result, an urgent need to call a doctor. In this case, surgery is performed.

A dangerous disease related to the absolute causes of surgical treatment is placental abruption. This problem can lead to the death of mother and child.

The danger of placental abruption for the fetus is to stop the delivery of oxygen and nutrients. Also there is a violation of blood circulation. Mom's life is threatened by sudden bleeding. The blood begins to leave the area of ​​the vessels located at the site of detachment. It is impossible to fix the problem. Only emergency caesarean section can help.

The doctor should suggest a planned operation if the baby is in the wrong position in the mother’s womb. Before delivery, the fetus must roll over its head. The legs should be directed strictly upwards. The fetus may not always take this position. Adoption of the correct position is also not a guarantee of successful natural childbirth. The fetus may incorrectly turn around with the onset of contractions. If he does not accept the position necessary for childbirth, surgical intervention should be carried out.

A weak uterine contractile activity is also considered pathology. It appears due to the lack of the hormone oxytocin or the genetic predisposition of the mother. The long process of cervical dilatation is fraught with complete relief of the child’s lungs from fluid. He may die before the start of the attempt. The condition of the fetus is monitored by a special apparatus that tracks the heart rate. If it decreases, the decision is made by the doctor within a short time.

Relative factors leading to a sudden operation

Recommendations for cesarean section may be relative. It is believed that these pathologies do not have a clear danger to the health of the mother and fetus. But sometimes they can lead to unexpected complications. Emergency caesarean section can be performed for pathologies such as:

• the presence of endocrinological pathologies;
• reproductive system infections;
• cardiovascular diseases;
• oncological tumors;
• myopic eye damage;
• carrying several fruits.

Diabetes mellitus is the cause of recommended cesarean section. Emergency intervention is carried out in the event of an increased risk of major blood loss. Bleeding may occur due to disruption of the vascular system. The vascular tissue of a healthy person has such properties as flexibility and elasticity. Endocrine disease causes the destruction of its own collagen. Against this background, the destruction of individual sections of vascular tissue. With the onset of contractions, an increase in blood pressure occurs. Weakened tissue does not withstand the pressure of blood and collapses. Through a gap the blood enters the cavity. If the contractions of the patient are accompanied by severe ruptures of the vascular tissue, it is necessary to perform an emergency operation using caesarean section.

Problems may also arise if there is a history of genital infections. Most of these diseases are caused by bacteria. Pathogenic microorganisms cause a change in the microflora of the vagina. If the child’s body is damaged or begins to move actively, it is recommended that the operation be performed. Otherwise, the fetus may be infected by the mother. We should not think that such infections for the health of the baby are not dangerous. After birth, the baby's skin is gradually updated. Peeling causes the formation of microcracks. Through them, the bacterium enters the children's body. Further development of the infection leads to a decrease in immune protection. The child is constantly sick of various diseases.

Other indications for surgery

Cardiovascular pathologies are diverse. Recommendation for cesarean section occurs when there is high blood pressure and heart muscle problems. Both diseases can sharply worsen during contractions. A rapid increase in pressure is dangerous by sudden bleeding. It can also damage the fetal nervous system. If the doctor does not perform an emergency C-section, the woman may die.

It is necessary to conduct a planned intervention in the presence of cancer tumors. Also, surgery is necessary for patients with uterine myoma. The neoplasm of various etiologies develops due to a violation of the structural composition of the tissue. Abnormal cells begin to actively proliferate. The danger arises from the damage to the surface of the tumor in the process of natural childbirth. Damaged pressure tissue may burst. If the doctor believes that the risk of such damage is high, the woman is sent for emergency surgery.

The relative cause of cesarean section is the presence of progressive myopia. Myopia can be congenital and acquired. Emergency intervention is often performed on the background of acquired myopia. This pathology of vision appears due to problems with the optic nerve, lens and retina. If childbirth involves retinal detachment, the woman needs urgent surgical intervention.

Emergency surgery is also needed for multiple pregnancies. The presence of two or more fruits reduces the gestation period. Increasing the weight of the fruit causes increased pressure on the lower part of the uterine cavity. To avoid possible complications should resort to elective surgery. If the woman decided on an independent birth, the operating room should be ready. Any change in the testimony of the vital activity of children is considered to be the cause for an emergency cesarean section.

Preparation and progress of the operation

With emergency caesarean section, preparatory activities are minimized. During the usual preparation for the operation, a special diet is assigned to the woman and water intake is prohibited. Enema is carried out both during normal childbirth and during surgery. Since the cesarean section is carried out urgently, the diet and the refusal of water are not appointed. A woman urgently gets into the operating room.

The course of the operation depends on the evidence that caused it. Often the incision is applied to the upper part of the pubic area. On this site of a fabric most densely adjoin. If the fetus needs to be pulled out quickly, then the uterus is dissected by a longitudinal incision.

Of particular importance is the material used for suturing. With the usual surgical intervention on the uterus sutures are made of self-absorbable material. But during emergency cesarean section, uterine wall injury may occur. To combine the edges of the incision smoothly, doctors use metal brackets. They allow the incision to smoothly connect the edges of the uterine wall. With this method of bonding muscle fiber properly fused.

Recovery stage

After an emergency caesarean section, a woman needs to fully recover. This period takes place in several stages:

The first stage begins immediately after removing the woman from anesthesia. The action of the drug adversely affects the patient's nervous system. The first watch is observed dizziness and severe nausea. This condition can persist throughout the day. At this time, the doctor recommends maintaining physical peace. Further physical activity should also be low.

On the second day, flocculent discharge from the uterus appears. Such flakes indicate an independent cleansing of the uterus from lohia. Lochia is formed by mixing the endometrium and fluid accumulated in the uterus. The first week there are heavy discharge from the vagina. Over time, lochia cease to appear. Discharge begins to lighten and gradually disappear.

On the fifth day, the woman starts to get milk. Lactation depends on the time of activation of prolactin. Lactation after an emergency Cesarean section may not normalize. Often, babies born by surgery feed on artificial formulas.

The time required to remove the seams is important. The removal of threads is carried out on the 7–10 day after the formation of a thin scar. To avoid wound discrepancies, sharp movements should be avoided. It is also forbidden to carry items heavier than 3 kg. Low physical activity should be maintained for 10 weeks.

Before childbirth, a woman should be screened. According to his results, the doctor chooses the method of labor. If problems arise in the course of natural activity, an emergency Caesarean section should be performed.