Sectio Caesaria ( SC )

SECTIO CAESARIA

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.