Caesarean Section Medical Presentation

Caesarean Sections PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Download Free Caesarean Sections medical powerpoint (ppt) presentation for your medical ppt presentation

Tags : obstetrics

Published on : Apr 06, 2018 | Views : 3196 | Downloads : 0

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

ppt slide no 1 content not found
Slide 2-

Presentation Outline Definition History Epidemiology Types Indications Risks/ complications Pre-Op Operation Anatomy of Anterior Abdominal Wall Post Op TOLAC VBAC
Slide 3-

Definition A caesarean section is a surgical procedure in which incisions are made through a woman’s abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more babies.
Slide 4-

History Three theories about the origin of the name caesarean; Roman legal code called Lex Caesarea-law stated that the baby should be cut out of the mother’s womb in the case that she dies before giving birth. 1st century AD story by Pliny the Elder, who claimed that an ancestor of Caesar was delivered in this way
Slide 5-

Derived from the Latin verb caedere, to cut The first recorded survivor 1500 in Switzerland: Jakob Nufer, a pig gelder, performed on his wife after a prolonged labour. March 5th, 2000, Inés Ramírez performed a caesarean section on herself and survived, as did her son.
Slide 6-

Epidemiology UK 25% and 30% of deliveries U.S. rate in 2011 was approximately 33% Maternal mortality (<0.1%) Case fatality rate for all caesarean sections is five times that for vaginal delivery
Slide 7-

Classification Elective usually booked days or weeks ahead of time and are conducted during daytime hours Emergency All other caesarean sections, irrespective of whether the woman was in labour or not.
Slide 8-

ppt slide no 8 content not found
Slide 9-

Abdominal Incisions Pfannenstiel/ Transverse curvilinear incision 2 fingerbreadths above the symphysis pubis extending from and to points lateral to the lateral margins of the abdominal rectus muscle
Slide 10-

2. A transverse suprapubic incision with no curve advantages of improved cosmetic results, decreased analgesic requirements and superior wound strength.
Slide 11-

3. A vertical skin incision lower midline incision made from the lower border of the umbilicus to the symphysis pubis, and may be extended caudally toward the xiphisternum.
Slide 12-

Indications : extreme maternal obesity surgical intervention for other intra-abdominal pathologies where access to the uterine fundus may be required (classical caesarean section).
Slide 13-

Advantages greater ease of access to the pelvic and intra-abdominal organs May be enlarged more easily Disadvantage higher incidence of wound dehiscence
Slide 14-

ppt slide no 14 content not found
Slide 15-

Uterine Incisions Low Transverse Uterine Incision Most commonly used Location: the non-contractile portion of the uterus The bladder must be dissected off the lower uterine segment. Risk of uterine rupture in subsequent labor : 0.5%.
Slide 16-

ppt slide no 16 content not found
Slide 17-

Classical/ Sanger Less commonly performed Location: made in the contractile fundus of the uterus Repeat cesarean should be scheduled before labor onset.
Slide 18-

Indications Emergency lower uterine segment fibroids lower segment covered with dense adhesions placenta previa, abruption transverse lie with the back down fetal abnormality (e.g. conjoined twins) carcinoma of the cervix Postmortem CS Cord prolapse
Slide 19-

ppt slide no 19 content not found
Slide 20-

Low vertical The vertical incision begins in the non-contractile lower segment but usually extends into the contractile upper segment
Slide 21-

Uterine rupture in future pregnancies (1) Low transverse scar (one): less than 1% (2) Low vertical scar: 0.5% to 6.5% (3) Classic scar: as high as 10%
Slide 22-

Indications The four major indications accounting for greater than 70% of operations are: Previous caesarean section. Malpresentation (mainly breech). Failure to progress in labour (CPD). Suspected fetal compromise in labour. Other indications, such as multiple pregnancy, placental abruption, placenta praevia, fetal disease and maternal disease, are less common.
Slide 23-

ppt slide no 23 content not found
Slide 24-

Risks Hemorrhage: Mean blood loss of 1,000 mL Causes Uterine atony Placenta previa Damage to uterine vessels
Slide 25-

Management oxytocin infusion, prostaglandins, bimanual compression, uterine compression sutures, hysterectomy. Indications for hysterectomy; uterine atony, rupture, extension of a transverse uterine incision and obstructive.
Slide 26-

• Infection: Sites of infection include endometrium, abdominal wall wound, pelvis, urinary tract, or lungs. Prophylactic antibiotics can decrease infectious morbidity.
Slide 27-

• Visceral injury: Surrounding structures can be injured (e.g., bowel, bladder, and ureters). • Thrombosis: Deep venous thrombosis is increased in the pelvic and lower extremity veins.
Slide 28-

References Sakala,P. (2016). USMLE STEP 2 CK Lecture notes 2017 Obstetrics and Gynecology. New York: Kaplan Inc. Kenny,L. (2017) .Obstetrics 20th Edition by Ten Teachers. Manchester, UK :CRC Press Taylor & Francis Group.