Most women looking for a spontaneous birth, but there are reasons that require an intervention in the course of the birth or the planning of a Caesarian section.
A caesarean section (Sectio caesarea) is necessary if the child is definitely too big, the placenta blocks the cervix, the child is in a birth-impossible situation (such as shifting) or the child must be born in a very early weeks of pregnancy. In this case, a planned (primary) caesarean section is performed before cervix effective labor or rupture of membranes.
One speaks of a secondary caesarean section, if the woman had cervical effective contractions or the amniotic sac has already jumped. The caesarean section is performed because for example, birth labour (in spite of all tools) are not sufficient or the heartbeat of the child give cause for concern, we speak of an unplanned (secondary) caesarean section. In this case, the birth should be as quickly as possible stops and the time between the decision to the caesarean section and the child’s development is no more than 20 minutes.
The preparations for the caesarean section
For the OP, you be shaved upper pubic area because hairs are a potential carriers. Also you get a bladder, which ensures that the urine to drain and the bladder is not filled during the surgery. As with every other OP, you must drop all jewelry and dentures and swap your clothes against an OP shirt and thrombosis stockings. Before the trip in the operating room, you get a citrate solution to drink. You don’t particularly like, but prevents nausea and vomiting.
After the anesthesia, the operating table is tilted 15 ° to the left to avoid a vena cava compression syndrome. Some women have a feeling of uncertainty. It may happen nothing, since the surgical staff has secured you previously accordingly. After the abdominal wall was disinfected and they were covered with sterile towels, may the attendant in the operating room.
So there are no misunderstandings, you should ask before the surgery. Please don’t be disappointed if you and your relatives see anything. The hygiene going on, therefore the partner only for you at the head may sit and talk to you. You have no views of the surgical field, because a sterile cloth is stretched in front of you.
Caesarean section: two different surgical procedures
Usually, the transperitonale development of the child through the opened lower portion of the uterus will be applied. It opens the abdomen just above the pubic symphysis with a cross section (surgical technique after Pfannenstiel Santia). To reach the lower part of the uterus, the surgeon cut through the peritoneum of the urinary bladder and pushes them out of the way. Now, the lower uterine segment (in the pregnancy unfurled lower part of the uterus) with a small cut can be opened. The cut is extended blunt, i.e. with the fingers. Same procedure with the amniotic sac.
Now, the baby out of the womb may be cancelled. This phase of the OP can be awkward for you because the operator must push the child through pressure on the upper abdomen towards the exit. The child is detached from and passed the midwife, satisfied with the anesthetist or the pediatrician of the vitality of the child.
Placenta and Eihäute are manually by solved the uterine wall and the cervical canal may be extended so that the week River can flow out. Uterus and abdominal cavity must be closed now in several layers. During this time, you can get a light sedative.
The “soft” cesarean section
Since 1995, also the Misgav Ladach technology developed in Jerusalem is used. In contrast to the above method, while the first cut set much higher, stretched the belly wall layers blunt (almost only with fingers), and refrain from pushing off the bladder. The development of the child and the development of the placenta and Eihäuten are the same.
The closure of abdominal ceilings without a seam of the peritoneum and the subcutaneous fatty tissue. All in all this shortens the conventional surgical time of approx. 30-40 minutes to about 15 minutes.
In the media, this form of the Caesarian section is described as the “gentle” the cesarean section. Is one “gentle” with pain-free or gently right, the term does not apply to, because stretching of the abdominal muscles requires strength. Rather, the term has its permission for the post-operative course. Several studies show a lower blood loss, less pain medication needs and shorter inpatient stays. Misgav – Ladach method is no longer applicable, if a previous cesarean section in the traditional way (Pfannenstiel – Santia) was conducted.
Birth forceps and vacuum extractor
While the caesarean section at each time of birth can be performed, there are preconditions for an end to birth by birth pincers (forceps) or suction (vacuum extraction). So for example the amniotic sac has jumped and cervix be fully opened that otherwise may not include the child’s head to pliers spoon or with the vacuum extractor no vacuum be built.
Similarly, an imbalance in the output of the basin must be excluded. If the obstetrician then opts for the birth forceps or the birth, depends on the height level of the child and the attitude of the head, because not such as a Bell can be applied to any part of the head.