Cesarean section – a surgery at which the child appears through a rassechenny belly wall and a wall of a uterus. As well as any other, it is carried out only on medical indications. The fear of future mother of natural childbirth is not an occasion at all in order that on her performed operation. Today almost every fifth child is born by means of this operation which gives to many women chance to become happy mothers.
Indications to Cesarean section
Sometimes in addition before pregnancy or during her doctors tell to the woman that Cesarean section – the only opportunity for it to give rise. In similar cases future mother should not panic, and to rely on competent opinion of physicians because she is often not capable to estimate adequately own state of health and possible risk for the child.
The list of indications to operation approved by the Russian Ministry of Health is rather extensive. They are divided into two groups: absolute (when childbirth is physically not possible, either from mother, or from a fruit) and relative (factors which are not connected with pregnancy, but can do much harm to mother or the child). For example, treat the first:
- very narrow basin of the woman in labor (III-IV degree);
- not compliance of the sizes of a head of the child and mother's basin;
- absolute prelying of a placenta;
- the existence of tumors on bodies of a small pelvis complicating pass of the child on patrimonial ways;
- early peeling of a placenta with strong bleeding;
- the seams and hems on a uterus predisposed to gaps;
- wrong provision of a fruit (across or obliquely);
- extreme stages of a gestoz;
- threat of a rupture of a uterus;
- serious diseases of TsNS, cardiovascular system, sight, etc.
- To the second:
- anatomic a narrow basin of I and II degrees, in combination with other indications (for example, a large fruit);
- phytoplacentary insufficiency in a chronic form (observed during all term of pregnancy);
- premature otkhozhdeniye of waters in combination with pelvic prelying of a fruit;
- weak prolonged patrimonial activity;
- loss of an umbilical cord at a fruit;
- prolonged (perekhozhenny) pregnancy;
- toxicosis on late terms of pregnancy.
To save life to the baby, and sometimes and mother, doctors should act very quickly – the account goes for minutes. From similar extreme situations any woman for this reason physicians are negative to carrying out childbirth in house conditions is not insured.
Planned operation is performed in terms, the most approximate by estimated time of natural childbirth. Often the pregnant woman comes to maternity hospital already with easy fights. In case of serious complications to the woman suggest to lay down in clinic in advance to spend the last weeks under supervision.
Date of operation is appointed. The last meal has to be no later than 6 o'clock in the evening on the eve of day of operation. It is necessary in case operation is planned to perform under the general anesthesia. Anyway conversation with the anesthesiologist who will make detailed recommendations about meal and waters is necessary to you. As well as before any other operation, the cleaning enema the night before becomes. That the woman well slept before important for her in the afternoon, to her give easy soothing preparations.
Prior to operation in writing future mother has to agree to operation of Cesarean section and to an anesthesia. Do not forget to warn the anesthesiologist if you had allergic reactions to any drugs, and report, what preparations you accepted the day before.
In modern clinics when carrying out planned Cesarean section epiduralny (peridural) anesthesia, and also the general intravenous or endotrakhealny anesthesia is applied. The decisive word, what method of anesthesia to choose, remains for the doctor, depending on a state of health of the woman and the kid.
The general anesthesia is entered through a vein then the woman falls asleep. At a similar method of anesthesia the woman in labor is unconscious and cannot take part in the course of events.
The Enodotrakhealny anesthesia also enters the person completely into a deep sleep, but it is given in the form of inhalation through a mask or special respirators. In cases of difficulty of breath at the patient or emergence of an emetic reflex such anesthesia is done through endotrakhealny tubes. This type of anesthesia reduces a dose of the injected drugs.
At medicine is entered into epiduralny space of a backbone through a catheter. The woman in labor does not feel a lower body pain (though some feelings nevertheless remain with it), however stays during operation in full consciousness. She cannot watch manipulations of doctors (the place where operation is conducted, is fenced off by a sterile sheet), but she hears the first shout of the kid, has opportunity at once after the birth to put it to a breast.
Each of types of anesthesia has contraindications. For example, epiduralny anesthesia cannot be carried out at a serious neurologic illness, infections, at violation of coagulability of blood. To reveal possible contraindications, for some time before operation it is necessary to pass inspection, to visit the therapist, the cardiologist, to make tests.
As a rule, planned operation is appointed to time having after round. On round the doctor once again does survey, after it is offered to be trained for operation (to put on a special shirt), by the fixed time the woman bring on a wheelchair in operational and move on the operating table. Also do the last preparations before operation: cover with a sheet, measure pressure, insert a catheter into a hand vein for introduction of medicines, including anesthesia. Use of a catheter allows to avoid a set of pricks and quickly to enter the necessary medicines in emergency situations.
Further the woman is given an anesthesia which dose is calculated so that impact on the child was minimum. When he starts acting, over hairy part of a pubis the skin cross-section, and then at the command of readiness of neonatolog of a uterus becomes (the section along a stomach from a navel to a pubis becomes only in the most extreme cases, for example, when on a uterus already there are some hems or operation becomes off-schedule in the emergency order). Such seam is considered the most physiologic and cosmetic. The seam on a uterus is sewn up with a thread which resolves itself in 3-4 months. Usually for the sixth or eighth day after operation the hypodermic thread is removed (procedure absolutely painless, but unpleasant if you are afraid, is better to turn away and not to look).
During operation for prevention of complications the woman is given a single dose of an antibiotic of a broad spectrum of activity which is completely brought out of an organism within 12 hours so the next days it is possible to start feeding of the kid.
The woman spends days after operation in chamber of intensive therapy where watch its pressure, pulse, temperature, reduction of a uterus. The container with ice is put on a stomach. From drugs she receives: anesthetizing, pricks for reduction of a uterus, and also a dropper with physiological solution for restoration of the liquid lost during operation.
The doctors anesthetizing pricks offer some more days but if the woman feels well, she will be able to refuse them soon. In the first day after operation she is allowed to drink still mineral water with addition of a lemon (the last can be added only if the kid has no allergic reaction).
If everything goes normally, on second day the woman transfer to the general office where she can rise, go, feed the kid and even is independent to look after him if in maternity hospital there are chambers "mother and child".
According to the protocol transfer to the general office is allowed only for 4 days after operation, but in practice from it often recede. From private life of acquaintances I know that for the 5th days they were already written out home with kids.
At this time it is necessary to put the child to a breast that he received the first drops of colostrum as often as possible.
The special attention is paid to restoration of work of intestines after an anesthesia. "To help" it to work, in the first days can give the stimulating injections.
For the second and third day after operation it is already possible to eat low-fat broth, the turned meat, cottage cheese, porridge. When work of intestines is adjusted, allowed to pass to a diet, habitual for it, taking into account that it the feeding mother now.
The earlier the woman will start moving, rather will be on the mend, it is considered that it will also reduce risk of emergence of postoperative solderings in an abdominal cavity, but solderings are unfortunately inevitable. It is worth thinking in advance of a postnatal or postoperative bandage which will facilitate the movement (it is necessary to put on it as required). In the absence of complications, having consulted to the attending physician, it is possible to start carrying out the elementary physical exercises (avoiding excessive loadings).
The extract after such operation becomes for 5-6 days, on condition of a normal state of mother and the kid. During this time the woman is observed, for 2-3 days becomes to make sure that is reduced normally and the seam from operation is made reliably. Though at vigilant and attentive survey by the gynecologist of ultrasonography it can not be demanded.
The condition of the woman is estimated by the same principles, as after usual childbirth. The main requirements are a soft breast (ability to decant surplus after milk stay), the normalized work of intestines (a regular chair), reduction of a uterus and normal allocations (lokhiya) – they are similar to usual periods: the first 2-4 days after the delivery plentiful and every day beginning to decline (in total duration of lokhiya about 6 weeks).
Here you and houses!
It is better if the woman, at least, within two-three months after operation does not lift anything heavier than the child (do not move a tray with water, do not drag a carriage on a ladder and, of course, forget about "bags with potato"). It is possible to wash at first only in soul, and with bathing in a bathtub and the pool it is necessary to wait until the seam begins to live finally.
As for sexual life, here it is necessary to wait a little one and a half-two months. It is considered that time at Cesarean section the child does not pass through patrimonial ways, the woman can not take into account council about abstention from sexual life within two months after the delivery. But it is not correct. This abstention is required for restoration of elasticity of a uterus, but not muscles of a vagina more likely. Plus is risk at this time to get the ascending infection.
The special attention needs to be paid as doctors do not advise to plan repeated pregnancy within two-three years – such time is necessary for an organism for a complete recovery.
In summary there is a wish to note that the medicine does not stand still and under certain circumstances once the made Cesarean section is not an indicator to the same way of birth of the subsequent children. Rebirth and subsequent children quite perhaps and natural way. Key parameter – existence of solderings and a solvency of a postoperative seam to the term of childbirth.