home Diseases Pregnancy calendar how much earlier do caesarean. In rare cases possible. emergency caesarean section

Pregnancy calendar how much earlier do caesarean. In rare cases possible. emergency caesarean section

Often during pregnancy during next examination the gynecologist reveals any abnormalities in the expectant mother or her fetus that may threaten their health or even life. In this case, he can decide on the need for operative childbirth, so that everything goes with minimal losses.

A pre-arranged planned caesarean section will allow the woman to get used to this thought and prepare for the operation. What are its advantages and disadvantages?

A planned caesarean section is not the norm. Therefore, you need to know in what cases this operation is performed. There is a range medical indications for surgical intervention in childbirth. There are a lot of them and they are caused by a variety of factors.

Are you planning to conceive or has it already happened? In this case, study this list to know for sure whether your baby will be born naturally or doctors will insist on an operation.

Maternal health:

incorrect placenta previa;
scar on the uterus;
if the previous caesarean was corporal, the next should be planned;
incision on the uterus T and J-shaped;
any uterine operations: resection, hysterotomy, myomectomy, etc.;
more than two caesarean sections;
HIV infection;
genital herpes that manifested itself less than 6 weeks before the birth of the child;
cardiovascular diseases: arterial hypertension, coarctation of the aorta, its aneurysm, cardiac ventricular dysfunction, pericarditis;
vision problems: retinopathy, perforated corneal ulcer, burns of the mucous membrane of the eye;
pulmonological, neurological, gastroenterological pathologies;
injuries or tumors of the pelvic organs;
cervical cancer;
severe form of late toxicosis;
plastic surgery on the perineum;
genitourinary, intestinal-genitourinary fistulas.

Fetal condition:

breech presentation after 36 weeks;
pelvic or any wrong position with multiple pregnancy;
transverse presentation;
monoamniotic twins;
growth retardation of one of the babies with multiple pregnancies;
gastroschisis, teratoma, diaphragmatic hernia, fusion of twins.

Here are the cases in which a planned caesarean section is traditionally prescribed. True, there are cases when the operation is prescribed at the request of the woman herself. This happens if she is afraid of pain or complications after vaginal delivery. However, doctors oppose such weakness (read our study:) and discourage CS if there is no medical indication for it. Otherwise, you will have to carefully prepare for surgical intervention.

Preparation

As soon as you know about the upcoming operation, ask the doctor in detail what is the preparation for a planned caesarean section, which will minimize Negative consequences and unwanted risks after childbirth. It includes several stages. First, you will need to put your body in order throughout your pregnancy. Secondly, immediately a few days before the operation, a number of appropriate measures will need to be taken.

During pregnancy

Be sure to ask the gynecologist who is observing you all the questions you are interested in and worrying about: how long you will be operated on, when you have to go to the hospital, are all your tests in order, etc. This will calm you down, give you confidence, relieve unnecessary worries.
Eat special courses designed to prepare women in labor for a planned caesarean. It would be nice if you sign up for them.
Visit your gynecologist regularly.
If you notice any abnormalities in your condition, immediately report them to your doctor.
Eat right.
Lead healthy lifestyle life.
Be physically active, but in moderation, as far as your health condition allows, because it was not in vain that you were scheduled for a planned operation.

We are going to the maternity hospital

Find out in advance and make a list for yourself of what to take to the hospital from things:

documents: passport, referral for a planned caesarean section, exchange card, insurance;
money;
things: a bathrobe, a nightgown with buttons, special bras, a towel, slippers;
hygiene items: pads, disposable diapers, toilet paper, shower cosmetics (preferably natural);
water;
disposable tableware;
for a child: diapers, diapers, sliders, powder;
charged phone.

Before a planned caesarean section, it is better not to shave the pubis itself. First, it's inconvenient. Secondly, you can bring an infection that will complicate the operation. It is better to find out in advance how women in labor are prepared in the hospital where you will be operated on: sometimes midwives prefer to do it themselves, but somewhere they swear if this area turns out to be unprepared. In addition, 2 days before the CS, you will not be able to take solid food, and 12 hours before you eat at all, so that anesthesia does not provoke vomiting.

Knowing how to prepare for the operation effectively and fully, you will no longer be afraid of it, as you will be sure of a successful outcome. You will do everything in your power to help the baby come into this world without complications. In order for the delivery to go perfectly, the date of the planned caesarean section must be scheduled in advance.

Timing

Most women are interested in what week they have a planned caesarean section, because very often doctors are silent until the last moment and delay setting the date of the operation. The fact is that the terms in this case are very individual and depend on a combination of many factors: on the characteristics of pregnancy, the state of health of the mother, the intrauterine development of the fetus, and even the mode of operation of the hospital in which you will be operated on. You can only take into account the following dates.

The norm for a planned cesarean: 39-40 weeks, i.e., the terms are as close as possible to natural childbirth. This is to minimize respiratory distress in the newborn. The first contractions are considered the ideal time for surgery.
Multiple pregnancy and maternal HIV infection: 38 weeks.
Monoamniotic twins: Elective caesarean section at 32 weeks.

In certain cases, the timing of a planned caesarean is not dictated by the child at all. With an incorrect placenta previa, the operation is performed before the first contractions go. There are other reasons to wait natural childbirth no time - too dangerous.

By knowing exactly how many weeks you will have surgery, you will prepare for a specific date. This will lower the anxiety threshold, allow you to maximize the time and effectively prepare for a planned caesarean section, which in this case takes place with minimal risks.

The course of the procedure

It is quite natural that future mom worries about how the planned caesarean section goes, how painful the operation is, what type of anesthesia will be used, how long it will all last. It is better to discuss all these exciting moments in advance with the doctor so that they do not interfere with enjoying the pregnancy and preparing for the birth of the baby.

Preparation

Conversation with the doctor, discussion of details.
In the evening, you are allowed to eat something light. In the morning they will not give you breakfast or even a sip of water.
On the day of the planned caesarean section in the morning, they will offer to shave the pubis. They will make an enema (why is it done before childbirth, read).
A catheter will be inserted into the bladder.
Put on a drip of antibiotics.
They will give you an anesthetic injection. The method of anesthesia for a planned cesarean is discussed in advance. Most women in labor want to see the baby in the first minutes of his birth, and therefore choose local anesthesia.

Caesarean

An incision is made. If it is, it is made along the old seam.
The child is removed.
The wound is sutured. This is the longest stage of the operation, requiring the surgeon to perform almost jewelry work. After all, how he stitches will depend on cosmetic defect, and the healing process.

Rehabilitation

The woman in labor is transferred to the department of anesthesiology and resuscitation for 1-2 days.
Support the body various drugs that are administered through a drip.
On day 3-4, in the absence of complications, the young mother is transferred to the ward.
You will also be allowed to get up for 3-4 days.
Weights over 3 kg will not be lifted for 2 months.
In the presence of pain in the lower abdomen, special medications are prescribed.

Planned caesarean section today is a common operation performed by many maternity hospitals, the technique of which has been honed to perfection. Doctors know all the nuances of operative delivery, even if something goes wrong. So do not worry and needlessly be afraid. Trust the doctors, follow all their instructions - and then you will not face any complications.

Possible Complications

Negative consequences of a planned caesarean section are still possible in rare cases. And they can touch the health and life of both the mother and the child. The most common and dangerous are:

profuse blood loss often leads to anemia;
difficulties with lactation, in some cases - its absence;
impossibility;
anesthesia renders harmful effect for a baby;
there is an assumption that a child with any caesarean (planned or emergency) does not produce proteins and hormones, which later have a huge impact on his mental activity and adaptation to the environment;
menstrual disorders;
injury to the abdominal cavity;
infertility;
thrombophlebitis of the veins of the pelvis, endometritis;
uterus removal;
violation of the baby's cerebral circulation.

Complications arise only in cases where the young mother ignored the prescriptions of doctors, when during pregnancy she led an unhealthy lifestyle. If you think first of all about your baby, he will definitely be born healthy, without pathologies, despite surgical intervention. High-quality, complete preparation for this event will shorten your time rehabilitation period after operation. This will allow you to quickly return to the usual rhythm of life.

Sometimes during the examination, the gynecologist finds various abnormalities in the expectant mother or her child that threaten health. In this case, the doctor decides on operative delivery so that everything goes smoothly, without problems.

For most women with problems, a caesarean section is the best option. It all depends on how the woman's pregnancy proceeds, and doctors have to decide on the type of delivery. When a planned caesarean section is done, the operation takes place with fewer complications than in the case of an emergency operation.

Planned operation carried out after 38 weeks, and emergency - at the beginning labor activity if something went wrong and there is a danger to the life of the woman in labor or the child. Cesarean is an operation that carries a number of risks, so it is done only according to indications:

Let's find out what week a cesarean section is done with a breech presentation. It all depends on the given situation. A pregnant woman with a fetus that sits in the womb is offered go to the hospital in advance at 37 weeks. If everything is in order, then the planned caesarean section takes place, as usual, at 38–39 weeks.

But at what time is a planned caesarean section done in the presence of several fetuses? Many twins are born prematurely - somewhere after the 37th week. A planned caesarean section for multiple pregnancies usually occurs at 38 weeks, and in the presence of three children - at 35-36 weeks.

Based on this information, the doctor decides when to perform the operation. Sometimes doctors in the maternity hospital advise the patient to wait until the day when the first light contractions begin. The woman is placed in the hospital ahead of time so that she was under observation at the onset of labor. Usually, a pregnant woman goes to the hospital a few weeks before the due date of the expected birth.

How is a planned caesarean? What week is a planned caesarean section? When is the second caesarean section done? These questions should be asked to your gynecologist, he will explain everything to you in detail so that you do not have any questions during the preparation and the operation itself.

They try to schedule a planned operation on time, close to natural birth. Independent onset of childbirth is not taken into account. Let's pay attention to what week they do a planned caesarean. The operation is usually done at 39–40 weeks of gestation, and at what time is the second caesarean? The second and third are done at week 38, sometimes earlier.

Caesarean section - preparation for surgery

How to prepare for surgery:

Most transactions are completed on time. spinal or epidural anesthesia. With this type of anesthesia, the woman is conscious, but she does not feel lower part body. She does not feel pain or touch.

The whole operation takes 40–50 minutes;
The doctor will make an incision in the abdomen and uterus (about 10 cm long). The incision is usually made just below the bikini line;
The child will be taken out through the incision and carefully checked;
then the child is placed on the mother's chest;
remove the umbilical cord and placenta;
sew up and treat the wound;
they will pierce antibiotics so that there is no infection and hemostatic drugs.

What happens after the operation

There are pros and cons of a caesarean

Pros:

there is no risk of lack of oxygen to the child during childbirth;
risk reduction birth injury a child during the passage of the birth canal;
reducing stress in anticipation of childbirth;
reduced risk of urinary incontinence

Minuses:

the child is born prematurely if the gestational age is incorrectly calculated;
sometimes when the uterus is cut, the baby is injured;
the danger that the intestines and bladder of the mother will be damaged;
increased maternal blood loss when a transfusion is needed;
risk of complications from anesthesia (pneumonia, allergic reaction, low blood pressure);
increased risk of infections, the appearance of blood clots in the mother;
decreased bowel function after surgery;
more time the woman is in the hospital;
longer recovery period;
possible complications when breastfeeding;
possible increased likelihood of clinical postpartum depression;
the appearance of adhesions on the uterus.

Second and third caesarean sections, what you need to know

Recovery after repeat cesarean takes longer and harder. The skin was cut twice in the same place, so it will take longer to heal than usual. The process of uterine contraction will increase, the woman will experience discomfort. There are complications with reoperation. They are different, it all depends on the health of the mother, the course of pregnancy and the development of the child.

Consequences for the newborn

circulatory disorders in the brain;
hypoxia.

If you have a second caesarean, don't worry! The main thing is to follow all the recommendations when preparing. All doctors know how many weeks they do a planned caesarean and they will definitely calculate everything so that there are no complications.

Recovery after cesarean

A woman needs more time to recover after surgery than after vaginal delivery. She will have to stay in the hospital for more days than a normal birth. She may experience some abdominal discomfort for the first few days and will be given pain medication. At home, you will not have to lift weights (after the operation you can’t) and follow the seam.

The number of births by caesarean section has increased significantly in recent years. In Brazil, the rate exceeds 56%, and the state is taking steps to reduce the number of surgeries without indications. WHO has set a clear percentage of operative births - this is 10-15% of all births in all countries. It has been proven that when 10% of all births in a state are assisted surgical operation, then the infant and mother mortality rate falls, as most women with health problems need it. IN different countries the percentage of transactions performed is different. In Brazil and the Dominican Republic, where about 56%, in Egypt, 51.8% of children are born by caesarean section, in Turkey (47.5%) and Italy (38.1%).

To date, planned caesarean section - very common operation conducted by different maternity hospitals. Doctors are aware of all the nuances of surgical delivery, know what to do if there are complications and answer the question “how many weeks is a cesarean?”. So do not worry in vain and do not be afraid. Trust the doctors, follow all their instructions - and then everything will be fine with you and your child.

Previously, women did not have the opportunity to give birth to a baby on their own after a caesarean section. But now everything has changed. The second caesarean (if there is no indication for it) is sometimes more dangerous than conventional childbirth due to great danger bleeding and other complications. Because of frequent occurrence adhesive processes is sometimes difficult to perform. But to say that after the operation, any woman can subsequently give birth to a child herself is fundamentally wrong. Each case is approached individually and, if there are no contraindications, the woman is prepared for conventional childbirth.

Repeat caesarean section, the ideal interval for childbirth

The ideal time interval between two pregnancies is an interval of 2 to 3 years. Over this period grows postoperative scar on the uterus after caesarean section, it is restored reproductive functions. During this period, unnecessary pregnancy should be avoided due to the fact that after an abortion, natural childbirth is likely to be impossible. The most optimal option is if the scar on the uterus is not noticeable, the longitudinal position of the fetus, head presentation, the real pregnancy is full-term, the placenta is away from the scar on the uterus.

Contraindications for childbirth after caesarean section

Contraindications for childbirth after a caesarean section are several reasons:

vertical scar after cesarean (it often breaks during childbirth);
large (weighing over 3500 kg) child;
abortions or miscarriages; a long interval between pregnancies (after 5-6 years, the scar becomes coarse and can break during labor);
complications after a previous operation;
development features real pregnancy- placenta ingrowth in the region of the seam, its presentation,
preeclampsia,
narrow pelvis.

When you can plan a second caesarean section, in what week

From 35 weeks, a pregnant woman is undergoing an ultrasound examination using a vaginal probe. After this procedure, it is already possible to find out whether a woman can give birth to a baby in a natural way. After a thorough examination of the pregnant woman, the doctor of the obstetric department issues a verdict: natural childbirth or re-operation of the cop.

It may be better to choose a natural birth rather than a second caesarean section, watch the video.

If a woman is allowed to give birth naturally, then childbirth should be carried out without stimulation of labor, so as not to provoke a rupture of the scar. During childbirth, both the condition of the mother and the condition of the baby are monitored with special attention; for this, CTG and ultrasound are performed.

It is possible that in the process of childbirth something will go wrong and there will be a need to resort to surgery again,. Repeat caesarean section is done in at 38 weeks. This happens sometimes and mom should be ready for this, it is desirable that the cop is planned, if you still decide on it.

Usually, the prospect of a caesarean section (CS) scares women in labor. However, CS allows a woman to know in advance the exact date and the time of the birth of the child and to carry out the birth as planned, without any excesses and unpredictable moments. However, many women are interested in why the gynecologist decides that delivery by caesarean section is necessary, and how the optimal time is determined, whether a planned caesarean section will be harmful to the mother and child.

What is a caesarean section?

A caesarean section is an operation in which the baby is removed from the uterus through an incision. abdominal wall. CS can be performed as planned, when the woman in labor and doctors know in advance about the operation, and urgently, if for some reason the woman for a long time cannot give birth on its own, and this begins to threaten her health and life.

What is a cesarean

Most often, doctors write in the patient's card not a detailed wording of the referral, but an abbreviation. Therefore, there are often situations when women find out already in maternity hospital that there will be no natural childbirth, but a planned caesarean section, and everything will happen in the coming days. Therefore, it is worth remembering the abbreviations: COP - caesarean section, the prefix "E" to the abbreviation means emergency, the prefix "P" - planned.

Difference between pacemaker and PKC

Since the pacemaker cannot be scheduled, an experienced gynecologist later dates pregnancy, it may suggest that such an outcome of pregnancy is also possible, but the chance to give birth on your own is still either higher than expected, then it will be written in the direction that an EX is possible.

If a planned caesarean section is expected, then this will be indicated in the direction, the reasons leading to such a decision will also be indicated, the direction itself will be issued on a specific date. In addition, some referrals are not issued to a specific maternity hospital, but with an open “place”, so that a woman in labor can independently choose the hospital where she will give birth, having previously met with obstetricians and anesthesiologists, and sometimes with specialized doctors, such as cardiologists or traumatologists .

The difference between the pacemaker and the ACL is sometimes seen in how the incision is made. If the birth is very difficult, there are some serious problems, then the doctors do not reflect on the aesthetic appearance of the incision. Accordingly, it can take place anywhere in the abdomen, where it is convenient and as safe as possible. With PKC, the incision usually goes just above the pubis and most often even without the use of cosmetic sutures invisible to strangers.

Elective caesarean section is also safer for subsequent pregnancies and deliveries. Emergency CS, on the contrary, is less safe for women's health. After the pacemaker, a planned caesarean section is almost always prescribed for subsequent births in order to avoid other complications.

Indications for caesarean section

There are not always indications for such operations. But it happens that a woman herself is afraid to give birth, then the expectant mother herself informs the doctors about her desire. Closer to the date when a planned caesarean section is prescribed, you need to carefully prepare.

In addition to personal factors, there are other reasons directly or indirectly related to health. Thus, in the presence of immunodeficiency diseases, cancer, diabetes, diseases associated with the heart and blood vessels, and for any other diseases that affect the functioning of internal organs, as well as for severe edema associated with pregnancy, PCS will be prescribed, and the woman will not be able to give birth on her own. Of course, unless the woman in labor hides her illnesses and puts her life and the life of the child at risk.

A planned caesarean section will also be carried out if there are problems with the bones before or during pregnancy. common cause PCS is a strong divergence of the symphysis (symphysitis).

Possible indications may be organs that are not sufficiently prepared for the time of childbirth, for example, an insufficiently opened uterus with already departed waters. Then the doctors decide to administer oxytocin, but if it does not help, an ECS is performed.

In what cases do EX

The EKS is done if the pregnancy proceeded normally, the woman in labor is healthy, the fetus too, but circumstances have arisen that can lead to injuries and other bad consequences. In this case, the operation is performed for a period of 38-42 weeks.

Usually, an ECS is performed if, during childbirth, the child in the womb begins to choke or there are obvious problems with the blood flow in the fetus or mother. In such situations, the COP may be at a period of 36 weeks or earlier. Also, an emergency delivery passes if the water has already broken for several hours, and the uterus has not opened enough for the baby to pass. Most often, such situations occur on terms from 36 to 40 weeks.

There are also cases when the child simply gets stuck in the birth canal. This happens if the fetal head is too large. In this case, doctors are also forced to resort to a pacemaker to eliminate the risks.

Less often, ECS is resorted to when pregnancy is overdue, when from the moment the last critical days more than 42 weeks have passed, as well as with an incorrect location of the fetus, for example, with frontal insertion of the fetal head.

At what time do PCS

It is impossible to say unequivocally at what time a planned caesarean section is done, since each woman has her own gestational age. Complexity correct definition term lies in the fact that pregnancy lasts 38-42 obstetric weeks. However, they do not show the actual age of the fetus. If we are talking about natural insemination, the actual terms may differ from the obstetric ones up to 4 weeks, and this is quite a long time. At the same time, the doctor needs to know how mature the child is, whether his life support systems are working, and even an ultrasound scan will definitely not be able to show this.

Partly because of the above reason, a planned caesarean section is scheduled at 39 weeks and later, if there are no additional indications, which include circumstances that affect the health of the woman in labor with a longer pregnancy. That is, for some types of diabetes mellitus, a CS is prescribed as early as 36 obstetric weeks, and sometimes even earlier, since it is more profitable for doctors not to risk the life of a woman in labor and a child, removing an already overwhelming burden from a woman’s health and shifting it to devices for further and better development child, thus doctors save many lives.

There are no defined boundaries. When is a planned caesarean section performed? Increasingly, doctors are looking at the underlying circumstances and how the child might be formed. But such conditions work only in the case of natural fertilization.

At the same time, if the insemination was artificial, then even from the moment of IVF, doctors will know the timing of the planned caesarean section, if the operation becomes necessary.

How often can PCS be done?

How often can a planned caesarean section be performed and for how long? Can be done multiple times. But you need to remember that CS is an operation on the uterus, the incision from which, of course, heals, but the scar remains. Thus, every second planned caesarean section is another scar on the uterus, which means that after two or three operations, the flexibility and strength of tissues is significantly reduced, there is a danger premature birth, gaps and many other problems.

Due to the consequences associated with the deterioration of the uterus, doctors try to resort to CS as little as possible, unless there are any special indications for this. Also, the practice is becoming more and more widespread when, after PCS, obstetricians try to deliver a woman in a natural way, and only if the attempt is not justified, they perform an ECS.

There should be at least a year between CS and re-pregnancy. However, it is not uncommon for women to become pregnant within the first six months after a planned caesarean section. The second birth is again a surgical intervention. The CS is repeated again in a year and a half after the first operation, which negatively affects the health of the woman in labor.

How to prepare for PCS

Before starting preparation, you need to find out from the gynecologist how long a planned cesarean section is done in a particular case, when a referral will be issued, and proceed in subsequent actions precisely from the doctor’s decision.

After the gynecologist determines the indications and the term, he can recommend the most suitable one or give a referral to the specialized maternity hospital, if there is evidence. Usually, in the presence of immunodeficiency diseases in a woman in labor, she is sent to give birth in specialized institutions.

After receiving a referral, a woman can either wait when she needs to go to the hospital, or go to get acquainted with obstetricians and anesthesiologists. The second approach is considered the most comfortable, since a few weeks before the CS, the woman in labor will be told and shown everything, if there are concerns, she can visit other institutions, as well as go to a psychologist. Thus, the stress from the upcoming operation will be reduced.

How does PCS work?

Depending on whether a planned caesarean section and for how long, the complexity of the operation for the child and his mother will depend. Within the standard framework, namely at 38-40 weeks of gestation, PCD passes quickly and without fear for the woman in labor.

During the operation, an incision is made in the abdominal wall and uterus, the child is taken out, the umbilical cord is cut, and the placenta is removed. After that, the fabrics are sutured.

But if the PCS was scheduled for one date, but for some reason the birth began before the CS and complications appeared, then the operation will take longer. It will be associated with other procedures or operations to preserve health and life. But this set of circumstances is incredibly rare, and all because doctors refer women to the hospital one to two weeks before ACL.

Operation duration

It is the operation that lasts from 20 to 40 minutes, but the preparation and subsequent manipulations go beyond this time period. The preparation includes the introduction of anesthesia, disinfection of the place being prepared for the operation, connection of the necessary equipment.

After the operation, the woman may be conscious, or may be under anesthesia. It also has its own nuances. The time of withdrawal from anesthesia is different for each person, while anesthesiologists do not always prefer serious medications, and then during the CS the woman in labor is conscious, although she does not feel pain. In this case, there is no need to withdraw from anesthesia.

Also, the operation often ends with a “refrigerator”, then the woman from the birth is taken to a room where low temperature. This is done to exclude possible bleeding. In the "refrigerator" a woman can spend several hours.

Recovery after PCS

If the doctors performed the CS on time, correctly sutured, removed the placenta and did not leave blood clots, then partial recovery after cesarean takes place within two weeks, during which time the woman can already stop experiencing pain and discomfort from the suture, start without problems and outside help lift the child in your arms. Within three months, the seam is already completely overgrown, the discomfort associated with the seam and stiffness of movements disappear, and problems with the stool disappear.

Psychological state after CS can also change as well as physiological. Therefore, after surgery, women are advised to seek the help of a psychologist.

Already after the second dissection of the uterus during childbirth, a woman is often offered to undergo sterilization, since the third caesarean section will cause irreparable harm maternal and child health.

Why is the third caesarean dangerous?

Conducting a triple dissection of the uterus and abdominal cavity is fraught with such complications as:

inflicting wounds to the intestines;
damage to the bladder and ureters;
violation of the natural placement of the pelvic organs;
adhesions in the area of the scar;
persistent hypotonic bleeding;
uterus removal;
intoxication and fetal hypoxia.

The risks of a third caesarean are extremely serious, medically justified and require the woman to be familiarized with their likelihood in advance.

Is a third pregnancy possible after a second caesarean?

When planning a third child, it is necessary to observe the time interval during which the seam will become complete and the entire body will recover. The process of the third gestation will be under careful medical supervision, and will proceed with the same pathologies as the previous ones. A third pregnancy after a caesarean section has a small chance of ending naturally, but the risk is not recommended.

Third caesarean in a year

The ideal option for a subsequent pregnancy is its onset at least 2-3 years after the previous dissection. The onset of unwanted fertilization must be prevented by taking contraceptives. Additional trauma to the uterus by abortions, curettage or forced births in the early stages is not allowed.

Is a third caesarean dangerous?

There is no doubt, since each surgical intervention in the work of the body causes some harm. Especially if it is intended for the same body. Permanent scar, chronic endometritis, anemia - the minimum "set" of a constantly cesarean woman. Therefore, after the third caesarean, doctors will insist on sterilization in order to avoid lethal outcome.

Third caesarean at 40

Sometimes women "ripe" for a third child when the number of years begins to exceed the mark of 40. And there may be an unplanned pregnancy after 40 years. It is not age itself that is important here, but the time interval from previous births to pregnancy and the state of health of the intended mother. In any state of affairs, it is necessary to undergo a thorough examination of specialists who will assess the situation and offer suitable way delivery. And not everyone will be able to decide on a caesarean section for the third time.

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If the doctor hears that this will be the third caesarean, then his eyebrows will fly up to the ceiling. Few agree to undergo this operation for the third time, usually two are enough through the roof. And doctors already during childbirth suggest sterilization to avoid the next pregnancy, because the risk of a third cesarean section is simply huge, and the pregnancy itself after two operations will already be unhealthy. This, of course, does not stop some, and they will go to the third cesarean and the fourth for the sake of the children. But is it worth it?

Third caesarean section - risk and complications

A third caesarean section is a risk, and a huge one at that. And any doctor will definitely warn you that you can voluntarily agree to this only if health is not expensive and own life. And even the best obstetricians are unable to prevent most of the consequences of the third caesarean section, because the body after two operations will be completely unpredictable.

Complications in the third caesarean may be the following: injury to the intestinal region and bladder, deformity of the pelvic organs, displacement or perforation of nearby organs. The formation of adhesions in the area of scarring, uncontrolled and unstoppable bleeding, the need for amputation of the uterus, fetal hypoxia, due to the fact that anesthesia will have to be made longer.

Should I have a planned caesarean section?

In recent decades, more and more babies are born by caesarean section (CS). In some maternity hospitals in the CIS countries, CS rates reach 50% of all births. In 2005, WHO conducted a study showing that with an increase in the frequency of CS, the frequency of prescribing antibiotics in postpartum period increase in maternal morbidity and mortality. On average, caesarean section occurs in 15 births out of 100, while a further increase in the frequency of CS does not lead to a decrease in perinatal morbidity and mortality in children.

Given the relatively high frequency of CS, any opportunity to reduce the risks associated with operative delivery will have significant benefits both for individual women in labor and in terms of economic costs.

Compared with vaginal delivery, maternal mortality rates for CS (40 per 10,000 cases) are 4 times higher than for all types of vaginal births, and 8 times higher than for normal vaginal births (5 out of 10,000 cases).

Planned caesarean section

A caesarean section can be performed as planned, when the doctor, together with the woman in labor, decides in advance on operative delivery, as the most safe way delivery, or urgently, when there are indications for urgent operative delivery. Even when registering, an obstetrician-gynecologist collects an anamnesis of a pregnant woman. Based on this information, he decides on the type of delivery recommended for this woman. Indications for a planned caesarean section can be both on the part of the mother and on the part of the fetus.

These include the following states:

From the mother's side:

Placenta previa, which is confirmed ultrasound after the 36th week of pregnancy (the edge of the placenta is less than 2 cm from the internal os);

A scar on the uterus in the presence of contraindications to subsequent vaginal delivery:

The presence of any contraindications to vaginal delivery;
Previous corporal CS;
Previous T and J-shaped incision on the uterus;
History of uterine rupture;
Any previous reconstructive operations on the uterus, resection of the uterine angle, hysterotomy, myomectomy with a history of penetration into the uterine cavity, laparoscopic myomectomy in the absence of uterine suturing with modern suture materials;
More than one CS in history. As an exception, vaginal delivery is allowed in women who have undergone 2 CSs, if there is at least one vaginal delivery in history;
A woman's refusal to attempt vaginal delivery;

HIV-infected women:

women taking three antiretroviral drugs and having a viral load of more than 50 copies per 1 ml;
women taking zadovudine monotherapy;
Women infected with HIV and hepatitis C at the same time.

in such cases, the CS is indicated for a period of 38 obstetric weeks, before the rupture of the membranes;

The appearance of genital herpes for the first time 6 or less weeks before delivery;

The presence of extragenital pathologies (the diagnosis must be established or confirmed by a specialized doctor):

from the side of cardio-vascular system- arterial hypertension of the III degree, coarctation of the aorta (without surgical correction of the defect), aortic aneurysm or other major artery, left ventricular systolic dysfunction with ejection fraction
ophthalmic - hemorrhagic form retinopathy, perforated corneal ulcer, wound eyeball with penetration, "fresh" burn. Other pathologies of the organs of vision are not an indication for CS;
pulmonological, gastroenterological, neurological pathologies in which the attending physician recommends childbirth by CS;
Tumors of the pelvic organs or the consequences of a pelvic injury that prevent the birth of a child;
Cervical cancer;
Conditions after a rupture of the perineum III degree or plastic surgery on the perineum;
States after surgical treatment genitourinary and intestinal-genital fistulas;

From the side of the fetus:

Breech presentation of the fetus after the 36th week;
Breech presentation or incorrect position of the fetus in multiple pregnancies;
Transverse presentation of the fetus;
Monoamniotic twins;
Syndrome of growth retardation of one of the fetuses in multiple pregnancies;
Gastroschisis, diaphragmatic hernia, spina bifida, fetal teratoma, twin fusions - subject to the possibility of rendering operational assistance newborn baby;

COP at the request of a woman in the absence of the above indications is not carried out. There are discussions about this in medicine. On the one hand, women want to decide on their own how to give birth to a child, and on the other hand, a caesarean section is an operation and is associated with many risks for the mother and fetus. If a woman refuses the indicated operation, she must sign an informed refusal with her own hand.

Scheduled caesarean section

Elective CS is performed after the full obstetric 39 weeks of pregnancy. It has to do with minimizing respiratory distress syndrome(RDS) in a newborn.

In the case of multiple pregnancies, elective CS is performed after 38 weeks.

In order to prevent vertical transmission of the disease in case of HIV infection of the mother - at 38 weeks of pregnancy, before the discharge of amniotic fluid or before the onset of labor.

In case of monoamniotic twins, the operation of the CS should be performed at a period of 32 weeks after the prevention of fetal RDS (special injections are made to help open the lungs).

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When is a planned caesarean?

As you know, a cesarean section is nothing more than a surgical intervention, during which the fetus is removed from the mother's womb using an incision in the anterior abdominal wall and uterus. The decision to hold such planned operation taken depending on the presence of indications that do not allow natural childbirth.

At what gestational age is a planned caesarean section performed and what are its advantages?

With this kind surgical intervention the likelihood of uterine rupture is sharply reduced. Besides? various kinds of complications observed during vaginal delivery during cesarean are less common. The operation also reduces the risk of uterine prolapse, which prevents heavy, uterine bleeding during childbirth.

If we talk about how long a planned cesarean is done, then this is most often 39 weeks. The thing is that it is by this time that a substance such as a surfactant begins to be produced in the body of the fetus, which contributes to the opening of the lungs at the first breath of the baby. If the operation is performed earlier than the specified period, the baby needs artificial ventilation of the lungs.

Who is scheduled for a planned caesarean?

This kind of surgery is not always prescribed. The main indications for its implementation are:

peculiarities anatomical structure(narrow pelvis);
the presence of mechanical obstacles to childbirth in a natural way (myoma, bone deformities, tumor);
having had a caesarean section in the past.

As for the last point, earlier, if a woman had already had a birth by caesarean section, then the subsequent ones were also carried out. Today, if there is a dense scar on the uterus, childbirth can also be carried out through natural routes. However, a repeated caesarean section is mandatory in the presence of such complications as a vertical incision of the uterus, uterine rupture, violation of placenta or fetus previa.

If we talk about how long the second planned cesarean is done, then usually it is the same as with the first - 39 weeks. However, if there is a risk of complications, it can be carried out earlier.

Why is a caesarean section dangerous?

Like any surgical intervention, caesarean section is associated with the development of certain risks of complications. These primarily include:

the development of adhesions and scars, which subsequently fasten together the organs located in the small pelvis and the muscles of the abdominal wall. This is accompanied by unpleasant sensations, discomfort;
violation of placenta previa in subsequent births.
accreted placenta. This complication occurs when the placenta cannot detach itself from the uterine wall. Therefore, manual separation is required, which is accompanied by severe bleeding. This kind of violation is observed in cases where a woman has already had 3 or more cesarean deliveries in the past.

How is it happening recovery period after a caesarean section?

The first day after the operation, the woman is under the supervision of doctors in the postpartum ward. Pain medications are prescribed for several days after the operation. Wherein Special attention give the state of the uterus, observing its contractility.

The sutures placed on the anterior abdominal wall are treated daily antiseptic solutions and then removed for 7-10 days. In the absence of complications in the mother, and if the baby does not have any disorders and was born completely healthy, discharge home occurs a week after the caesarean section.

Thus, the choice of the period on which it is better to do the planned caesarean doctors determined based on the condition of the fetus and the pregnant woman. In the absence of any risks, such an operation can be performed with the onset of the first contractions in a pregnant woman.

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How is a cesarean section performed? - Sharmani.ru

How is the operation

An anesthetic is applied before a caesarean section is performed. As a rule, this is local anesthesia by epidural or spinal blockade. At the same time, the woman in labor remains fully conscious, local anesthesia affects only the lower part of the body, causing a feeling of numbness and blocking pain.

After anesthesia, the surgeon makes two incisions - an incision in the abdominal wall and an incision in the uterus. In most cases, these incisions are transverse (horizontal). With such incisions, there is minimal blood loss and a lower risk of postpartum infection, scars from transverse incisions heal well and leave strong scars. A longitudinal incision (from the womb to the navel) is made extremely rarely. The abdominal muscles during a "caesarean section" are not cut, but only pushed apart.

After that, the doctor sucks from the uterus amniotic fluid, removes the baby, separates and removes the placenta, and begins to close the incisions. uterus and abdominal cavity sutured with dissolvable surgical suture. The skin is also connected with a thread or metal brackets, which are removed before discharge from the hospital.

How long does a caesarean section take?

The date of "caesarean section" is set individually, after examination of the woman in labor. When setting deadlines, pay attention to:

child's weight;
the condition of the lungs, the child's ability to breathe independently;
the degree of aging of the placenta;
is there an entanglement of the fetus with the umbilical cord;
health status of the mother in labor high blood pressure, the work of the kidneys.

At what time is a planned "caesarean section" done?

A planned cesarean section operation, if there is no threat to the child and mother, is usually done in late pregnancy. Most often this happens at the 39-40th week.

"Caesarean section" with breech presentation

Breech presentation of the fetus is one of the most common indications for a caesarean section.

Natural birth of a fetus in a breech presentation is classified as pathological. At the same time, approximately 40% of them are successful - with proper attention to the woman in labor.

Without fail, a "caesarean section" is prescribed for posterior breech presentation, foot presentation, or a tilted fetal head. With this arrangement of the child, the woman in labor is usually prescribed prenatal hospitalization, approximately at the 37th week of pregnancy. This is done in order to comprehensive examination and decide on the correct delivery.

How to behave after a "caesarean section"?

Getting out of bed after a "caesarean section" occurs, the woman in labor can be six hours later. Active movement is allowed after you are discharged from the intensive care unit. After the operation, wear a special bandage for several days to facilitate movement.

For some time you will feel dizzy, weak, get tired quickly. It's quite normal condition, it will pass as soon as the body recovers. They are usually discharged from the hospital a week after the "caesarean section".

At home, there are also some restrictions. For example, you can take a bath only one and a half months after the operation, before that you will have to limit yourself to a shower. Sexual intercourse can be resumed after six weeks, but only after consulting a doctor. Try to rest more, avoid serious loads.

charmani.ru

Cesarean section | Growing family - pregnancy, childbirth, household

If there is only one relative indication, then in many cases natural childbirth is possible, and a caesarean section is performed, as a rule, if there are several relative indications.

Contraindications for caesarean section

After a kasarev section, the occurrence of inflammatory processes, That's why relative contraindication Before surgery, there may be factors contributing to the development of inflammation:

acute bacterial and viral diseases, long anhydrous period, duration of labor more than 14 hours, immunodeficiency states.

An absolute contraindication to caesarean section may be a violation of blood clotting and intrauterine fetal death.

The progress of the caesarean section

A caesarean section is done through a corporal incision or through an incision in the lower uterine segment. The corporal incision runs vertically from the umbilicus to the womb along middle line belly. The incision on the uterus passes through the entire body, also vertically. In this way, irreversible injury muscle fibers uterus, and there is significant blood loss, however, this method allows you to get better access to the fetus during surgery. Therefore, corporal caesarean section is used in emergency cases when childbirth needs to be completed as quickly as possible. This method is also used for delivery up to twenty-eight weeks of pregnancy. In all other cases, an incision is made in the lower uterine segment. With this type of operation, the incision passes along the growth line pubic hair, and on the uterus, the incision is also made transverse. In this case, blood loss is less, and the uterine fibers are better restored.

Both with a corporal incision and with an incision in the lower uterine segment, the course of the caesarean section is the same: first, the abdominal wall is opened in layers, then the muscle fibers of the uterus are dissected and the fetus is removed. After that, the fetal membranes and the placenta are removed. The entire operation takes about forty minutes. Extraction of the fetus occurs in the first five minutes of the operation, the rest of the time is occupied by suturing the incision on the uterus and layer-by-layer restoration of the integrity of the abdominal wall.

Postoperative period

The first 12-24 hours after a caesarean section, a woman spends under supervision in the intensive care unit. It is desirable to get out of bed on the first day to improve the blood supply to the uterus. From the first days it is recommended to wear postpartum bandage, although in maternity hospitals, the stomach is often pulled in with a diaper instead. It reduces pain. In addition, the first days the woman is given painkillers. If the sutures were applied with non-absorbable threads, then they are removed on the sixth - seventh day. Discharged on the eighth - tenth day, provided that postoperative period proceeded without complications.

Caesarea

Several factors affect the baby during a caesarean section:

general anesthesia drugs enter the bloodstream of the fetus,
fluid is not squeezed out of the lungs because there is no compression chest in the birth canal
with a planned caesarean section, the child leaves the womb when the doctors decide, and not himself.

Children born by caesarean section are more likely to have problems with the respiratory system, and muscle hypertonicity is often observed. Therefore, in the first year of life, such cesareans need to be monitored by a neuropathologist, swimming and massage are desirable. Although, in recent years, almost all adverse factors the effects of caesarean section on the fetus are taken into account by doctors and are neutralized during childbirth: anesthesia is often done epidural rather than general, so drugs do not get to the fetus, fluid is squeezed out of the lungs, and the operation is performed with labor naal. Subject to all these conditions, children after caesarean section do not differ from babies born through the natural birth canal.

Pregnancy after caesarean section

How the next pregnancy will proceed after a caesarean section largely depends on how the scar on the uterus was formed. If there was inflammation in the postoperative period, then the scar may be insolvent, that is, unable to withstand stretching during the next pregnancy.

It is recommended to take a break between caesarean and subsequent pregnancy at two years. But if you have become pregnant before, you should not worry too much. There are many examples of women giving birth normally, becoming pregnant 3-4 months after a caesarean section. Abortion after caesarean section can be much more dangerous repeated pregnancy, since there is a direct rough mechanical effect in the area of the scar.

After a caesarean section, vaginal delivery is possible in the absence of indications for a second operation, a full-fledged scar on the uterus and the obligatory desire of a woman to give birth on her own.

Sterilization after caesarean section

A woman is not recommended to have more than three caesarean sections, but some have had eight or ten such operations! Therefore, the doctor, before the third caesarean section, or even before the second or first, if there are any contraindications to subsequent pregnancies, may suggest sterilization along with the operation - the creation of artificial obstruction fallopian tubes. However, the decision is made only by the woman, and sterilization without her consent cannot be carried out.

Caesarean section at the request of the woman

Now many women, not wanting to "suffer in childbirth," ask for a caesarean section if they wish. It's not too much good idea because caesarean is an abdominal operation. This operation can have negative consequences for both the mother and the fetus, although they happen extremely rarely, so it should be carried out strictly according to indications and only in cases where natural childbirth is impossible or too dangerous.

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At what time is the second (third) planned caesarean usually done? Pregnancy and childbirth. Conferences on 7ya.ru

But I don’t know))))) usually at 38, but I don’t know))))) usually they put me at 38, but a lot depends on the seam ... my second one herself asked to be released before the hospitalization period - it was again EXA with this B has not yet gone to the RD .... 02/22/2012 23:16:13, GerberA