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Lower segment caesarean section
(LSCS) this is the most common of all the types of caesarean
section. Foetus is extracted from uterus by making incision on lower uterine segment by opening the abdomen. |
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Preoperative
procedure
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- You have to remain empty stomach for at least 6 hrs.
Take only water during labour.
- Abdominal wall is shaved and cleansed with soap
and water and is covered with sterile draping just prior to operation.
- You are placed in supine position on
the operation table. Intravenous fluids are given.
- Urinary bladder is drained by sterile catheter keeping it during operation. Abdomen is painted with betadine solution or savlon spirit.
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Anaesthesia
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General anaesthesia or spinal anaesthesia is given.
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Operative procedure
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- The cut is usually made horizontally
and the surgeon drains out the amniotic fluid.
- The head of the foetus is hooked out by right palm placed below the head, while
the assistant presses down the fundus of the uterus.
- On delivery of foetal head, mouth, throat
and nostrils are sucked by thin catheter attached to metal sucker connection with rubber tube
and electric sucker machine.
- By this time your uterus is made to contract with 0.5 mg ergometrine or 0.2
methergin.
- Shoulders are brought at the uterine incision by gently pulling on foetal head. Thereafter shoulder
and trunk are delivered
- Baby is placed across mother's thighs
and suction of throat is continued. Baby in most situations starts crying at delivery.
- Baby's cord is clamped and the baby is
then handed over to the theatre nurse.
- Placenta usually separates spontaneously, is delivered by gentle traction on the cord membranes
and are carefully removed.
- Incase spontaneous placental separation does not occur within half a minute, manual removal of placenta is done.
- The incised uterus is stitched up in layers.
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Post
operative
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- You will be encouraged to walk about soon after birth. Moving around
would not open up your stitches. The incision will be painful for a few
days.
- Stand tall, and cup your hands over the wound.
- By about two days after the operation, begin gentle exercises. A day or so later, when the dressing is removed, you can have a bath.
- The stitches will be removed five days after birth, unless soluble, and you will feel much better after a week.
- Avoid straining yourself for at least 6
weeks. The scar fades, usually in three to 6 months.
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Caesarean section and
breast-feeding
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Your breasts will fill up with milk just as if you had delivered vaginally.
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As you will need extra rest, you will appreciate being able to just take your baby to bed with you and leisurely feed him, instead of having to get up to wash bottles or bottle feed her.
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If you have general anesthesia, you will have to wait until you are alert before getting started.
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Cesarean mothers prefer the side-lying position. To assume this position, use pillows to support your back, your abdomen, and possibly your upper leg.
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Place your baby on his/her side, facing you and cradle him/her in your arm.
Pull him/her in close to you until your nipple touches his/her lip.
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Some women prefer to nurse in a sitting position.
If you do, bend your knees somewhat
and support your feet to lessen the strain on your abdomen. Place your baby on a pillow in your lap and cradle him/her in your arm.
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The clutch position or football hold is another position that relieves pressure on the abdomen.
While sitting, hold your baby on a pillow at your side as if s/he were a football.
Use your hand to support his/her head at your breast.
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