Sectio Caesaria ( SC )

Caesarean surgery is only done if there is congestion on normal delivery or if there are problems during delivery which can threaten the life of the mother and fetus . Circumstances which require a caesarean section , for example, fetal distress , birth canal closed placenta ( placenta previa totalis ) , meacet delivery , maternal hypertension ( preeclampsia ) , a baby in a breech or transverse position , as well as bleeding before delivery.

In some circumstances , this action can be planned caesarean section or decided far in advance. This operation is called an elective caesarean section . This condition made ​​where doctors found no medical problems in the mother or the mother has a disease , so it is not possible for a normal delivery . For example, maternal diabetes , HIV / AIDS , or heart disease , can be done by elective caesarean or emergency (emergency ) . Mean elective surgery done with careful planning long before the time of delivery . While emergency caesarean meant to do when labor is in progress , but as a state of emergency caesarean section should then be done .

Planned Caesarean section ( elective )
At a planned caesarean section ( elective ) , caesarean section was planned well before the scheduled delivery by considering the safety of both mother and fetus . Some circumstances be considered to be elective caesarean section , among others :
  1. Fetus with breech presentation : Do caesarean section in breech fetus at first pregnancy , suspicion of the fetus cukp labor bottlenecks that can occur ( feto PELPIC disproportion ) , fetuses with his head thrown back ( deflection ) , fetuses with umbilical cord winding , or a fetus with feet presentation .
  2. Twin pregnancies : At the bottom of a twin pregnancy fetal presentation seen whether the head , buttocks , or transverse . Vaginal delivery is still possible if the percentage is second fetus heads . However , thought to doing the first caesarean section in cases of fetal / bottom in addition to the presentation of the head. on ultrasound also see whether each fetus has its own amniotic sack separate , or they just have one amniotic sack . In the case of twin pregnancy with fetal amniotic only have one bag , the risk to each hook / concerns with each other going higher , so need to do caesarean terencana.Pada multiple pregnancy with fetal number more than two ( eg 3 or more ) , it is advisable to perform planned caesarean section .
  3. Placenta previa : means the placenta is covering the cervix and below . Because before birth the fetus gets oxygen and food supply , it is not possible placenta as media suppliers birth / first separated from the fetus because it can lead to fetal death . The placenta consists of a lot of blood vessels , the location of the placenta covering the birth canal , is very prone to bleeding . If the contraction of the uterus , the part of the placenta is rich in blood vessels will detach and cause severe bleeding that can threaten the life of the fetus and the mother .
  4. Maternal medical conditions : pre-eclampsia , diabetes ( diabetes mellitus ) , herpes , HIV / AIDS , heart disease , chronic lung disease , or tumors of the uterus ( myomas ) are the size besaratau cover birth canal , cysts that block fetal descent , as well as a variety of other circumstances are the things that lead to a cesarean section is preferred .
  5. Problems in the fetus : Mass in fetuses with oligohydramnios ( amniotic fluid bit ) or fetuses with developmental disorders .
Caesar Opereasi Emergency ( Emergency )
The definition of an emergency cesarean section if the operation is carried out when the delivery process has been going on . This had to be done because there are problems in the mother and fetus . Some of the circumstances that forced an emergency caesarean section , among others :
  • Obstructed Labor
This situation can occur in the first phase ( phase lilatasi ) or second phase ( when you push ) . If obstructed labor in the first phase , the doctor will give a drug called oxytocin to strengthen contractions of the muscles of the uterus . Thus the cervix can open . There are other techniques , which break the amniotic membrane or give cairaan intrafena if you are short infusion fluids / dehydration . If in ways that did not work , then it will do a cesarean section .
If labor stalled in the second phase , the doctor must decide soon whether assisted delivery with forceps or vacuum or caesarean section should be done immediately . Things into consideration to proceed with a vaginal delivery ( assisted ) or cesarean section , depending on the decrease in the bottom of the fetal head dikes , levees state capital , and the presence or absence of gravity on the fetus .
Obstructed labor is a common cause of cesarean section . Some reasons are taken into consideration is no longer effective contractions , the fetus is too large while a narrow birth canal mother , and fetal head position which allows the withdrawal tadak with vacuum or forceps .
  • Fetal Distress
When the fetus is stressed , he will lack of oxygen . On clinical examination tanpak that fetal heart rate decreases . Normally , during the contraction of the fetal heart rate decreased slightly , but will return to his native prekwensi , if :
  1. Umbilical cord prolapse : if the cord out through the mouth of the womb , he can pinch, so the blood and oxygen supply is reduced kejanin . This situation is dangerous if the fetus is abnormal vaginal birth , cesarean section requiring immediate action .
  2. Hemorrhage : If you experience heavy bleeding due to placenta separates from the uterus , or for any other reason , then it should do a cesarean section .
  3. Stress fetal weight : If the fetal heart rate dropped to 70x per minute , then a cesarean section should be done immediately . Normal fetal heart rate is 120/160x per minute .

Healing process
On the first day after birth , if necessary , you are given the drug in low doses . Some doctors will allow you to start eating solid in the first 24 hours . Those that wait until you pass gas ( fart ) which indicates that the gut is functioning normally .
On the second day , you will feel uncomfortable in the abdomen . This happens because the digestive organs are back to normal after beraktipitas got painkillers that stop aktipitasnya .
Healing each mother is different depending on the durability and the effects of drugs used . If during the monitoring of your condition is stable , then the doctor will let you go home . Do not forget to return control medicine , approximately after two weeks.

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