Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Acknowledgements
- List of abbreviations
- 1 Maternal physiology and obstetrics
- 2 Antenatal care
- 3 Induction of labour
- 4 Normal labour
- 5 Abnormal labour
- 6 Fetal monitoring
- 7 Pre-eclampsia and hypertensive disorders of pregnancy
- 8 Operative obstetrics
- 9 Obstetric haemorrhage
- 10 Thromboembolic disorders of pregnancy
- 11 Infection
- 12 Life support in obstetrics
- 13 Drugs in obstetrics
- 14 Confidential enquiries into fetal, neonatal and maternal death
- Appendix 1 Adult Advanced Life Support Algorithm
- Appendix 2 The Management of Postpartum Haemorrhage Algorithm
- Appendix 3 Emergency Management of Eclamptic Fit Algorithm
- Index
- References
8 - Operative obstetrics
Published online by Cambridge University Press: 21 August 2009
Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Acknowledgements
- List of abbreviations
- 1 Maternal physiology and obstetrics
- 2 Antenatal care
- 3 Induction of labour
- 4 Normal labour
- 5 Abnormal labour
- 6 Fetal monitoring
- 7 Pre-eclampsia and hypertensive disorders of pregnancy
- 8 Operative obstetrics
- 9 Obstetric haemorrhage
- 10 Thromboembolic disorders of pregnancy
- 11 Infection
- 12 Life support in obstetrics
- 13 Drugs in obstetrics
- 14 Confidential enquiries into fetal, neonatal and maternal death
- Appendix 1 Adult Advanced Life Support Algorithm
- Appendix 2 The Management of Postpartum Haemorrhage Algorithm
- Appendix 3 Emergency Management of Eclamptic Fit Algorithm
- Index
- References
Summary
This chapter explains the indications for the Caesarean section organised into four categories. In principle, the considerations are that the decision to delivery time for category 1, where immediate threat to life of women or fetus, should be less than 30 minutes and mother's safety is paramount. The majority of deliveries are achieved through a low transverse abdominal skin incision and a transverse incision through the lower segment of the uterus. The chapter discusses the maternal or fetal compromise, the necessity of early delivery, and elective Caesarean section, explaining their ractical surgical steps, complications, and Caesarean hysterectomy. Instrumental delivery can be achieved through the use of vacuum extractor and forceps. Obstetricians should remain familiar with the technique of assisted vaginal breech delivery, as some patients will present with breech presentation in preterm labour or in advanced labour. Twin pregnancies have a higher incidence of pre-term labour, IUGR and preeclampsia.
Keywords
- Type
- Chapter
- Information
- Obstetrics for Anaesthetists , pp. 88 - 106Publisher: Cambridge University PressPrint publication year: 2008
References
Royal College of Obstetricians and Gynaecologists, The National Sentinel Caesarean Section Audit (London: Royal College of Obstetricians and Gynaecologists Press, 2001).
National Collaborating Centre for Women's and Children's Health, Caesarean Section Clinical Guidelines (London: Royal College of Obstetricians and Gynaecologists, April 2004).
Royal College of Obstetricians and Gynaecologists, Thromboembolic Disease in Pregnancy and the Puerperium. Guideline Number 28 (London: Royal College of Obstetricians and Gynaecologists Press, 2004).
Confidential Enquiry into Maternal and Child Health, Why Mothers Die? 2000–2002 – The Sixth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom (London: Royal College of Obstetricians and Gynaecologists Press, 2004).
, , et al., Blood transfusion and Caesarean delivery. Obstet. Gynecol., 108:4 (2006), 891–7.Google Scholar
Royal College of Obstetricians and Gynaecologists, Operative Vaginal Delivery. Guideline Number 26 (London: Royal College of Obstetricians and Gynaecologists Press, 2004).
, , , and , Early maternal and neonatal morbidity associated with operative delivery in second stage of labour: a cohort study. Lancet, 358 (2001), 1203–7.Google Scholar
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, External cephalic version: new interest and old concerns. Int. J. Obstet. Anaesth., 10 (2001), 263–6.Google Scholar
Royal College of Obstetricians and Gynaecologists, The Management of Breech Presentation. Guideline Number 20b (London: Royal College of Obstetricians and Gynaecologists Press, 2006).
Royal College of Obstetricians and Gynaecologists, Methods and Materials used in Perineal Repair. Guideline Number 23 (London: Royal College of Obstetricians and Gynaecologists Press, 2004).
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Royal College of Obstetricians and Gynecologists, Third and Fourth Degree Perineal Tears Following Vaginal Delivery – Management. Guideline Number 29 (London: Royal College of Obstetricians and Gynaecologists Press, 2004).
Royal College of Obstetricians and Gynaecologists, Thromboprophylaxis During Pregnancy, Labour and Delivery. Guideline Number 37 (London: Royal College of Obstetricians and Gynaecologists Press, 2004).
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