CESAREAN SECTION

General Information

DEFINITION--Delivery of a baby through an incision in the mother's lower abdominal and uterine walls.

BODY PARTS INVOLVED--Uterus; abdominal wall; placenta; placental membranes; fetus.

REASONS FOR SURGERY--

Danger to the mother or baby from one or more of many causes, including:

• Baby's head too large to pass through the birth canal. > Baby in the wrong position to pass through the birth canal. > Insufficient contractions of the uterus. > Abnormal attachment of placenta. > Failure of normal labor in a patient who had a previous Cesarean section. > Acute herpes genitalis infection.

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Poor nutrition.
• Excess alcohol consumption.
• Placenta previa with excessive blood loss.
• Toxemia of pregnancy.
• Chronic heart or lung disease.
• Use of drugs, such as antihypertensives; cortisone; diuretics; or insulin.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES--Obstetrician-gynecologist.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; sonogram (See Glossary).
• After surgery: Blood and urine studies.

ANESTHESIA--Local anesthesia by injection and spinal anesthesia by injection.

DESCRIPTION OF OPERATION

• An incision is made in the abdomen.
• Another incision is made in the uterus.
• Baby and placenta are removed.
• The uterus is closed and the abdominal contents are replaced. Connective tissue, muscles and skin are closed. The skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding or surgical-wound infection.
• Postoperative anemia.
• Endometritis (inflammation of lining of uterus).

AVERAGE HOSPITAL STAY--3 to 5 days.

PROBABLE OUTCOME--No complications expected. Allow about 4 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain.
• Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
• Take hot baths to relax muscles and to relieve discomfort.
• Don't douche unless your doctor recommends it.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Resume driving 3 weeks after returning home. > Resume sexual relations when able.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing.

Call Your Doctor If

Any of the following occurs:

• Bleeding soaks more than 1 pad or tampon each hour.
• An area on the breast becomes hard, warm, tender or reddened.
• Nipples become sore or cracked.
• The urge to urinate frequently persists longer than 1 month.
• Vaginal discharge persists beyond 1 month after surgery.
• Pain, red streaks or warm areas appear on the calf of one of the legs.