Introduction
Cesarean delivery in the United States
Cesarean delivery risks
Maternal mortality and morbidity
Neonatal morbidity
Cesarean delivery on maternal request
Patient preparation
Delivery availability
Indication
- Prior C-sec
- Labor dystocia (m/c)
- Abnormal fetal presentation
- Fetal distress
- ????
- ??? (5kg)
- ??-?? twin
- HIV, Herpes
- Cervical ca.
- ?? ?????
- Diagonal conjugate <11.5cm
?? ??: ?? ??? ???? ?, 39? ??
Informed consent
Timing of scheduled cesarean delivery
Preoperative care
Infection prevention
Surgical safety
Cesarean delivery technique
Laparotomy
| Low transverse | ? ?? | VBAC ??, m/c | ?? ? | ?? ?? (?????) |
| Low vertical, Classical | ? ?? | VBAC ?? | ?? ? | ?? ?? (??, ??) |
Classical? ?? ??: transverse lie? ???, ?? ?? ??(low incision? ??x)
Hysterotomy
Peripartum hysterectomy
Indications
- Uterine atony (bleeding? m/c cause)
- Abnormal placentation (??? ? ????) ? bleeding, accreta
- Ovarian neoplasia (ca.? ??)
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