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15 - Emergency caesareansection

from Section 3 - Intrapartum Emergencies

Published online by Cambridge University Press:  05 November 2012

Edwin Chandraharan
Affiliation:
St George’s University of London
Sabaratnam Arulkumaran
Affiliation:
St George’s University of London
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Summary

Depending on the urgency, caesarean sections (CS) are categorised as: grade 1, grade 2, grade 3 and grade 4. Grades 1-3 are all types of emergency CS with differing degrees of urgency. Regional anaesthesia is appropriate for the majority of cases but general anaesthesia may be needed in a grade 1 CS. Lower segment transverse incision is the commonest incision used and is associated with the lowest intra-operative haemorrhage as the lower segment is thin at this level. Classical incision is a rarely used vertical incision in the upper segment of the uterus. Vicryl no.1 on a blunt needle for uterine closure and Vicryl no.1 on a sharp needle for rectus sheath are commonly used sutures. Manual separation of the placenta before spontaneous separation increases the blood loss during CS and also the risk of postoperative endometritis.
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Obstetric and Intrapartum Emergencies
A Practical Guide to Management
, pp. 107 - 114
Publisher: Cambridge University Press
Print publication year: 2012

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