Cesarean Section (C-Section)
Introduction
Surgeons perform the Cesarean Section (C-Section) procedure to deliver the baby through abdominal and uterosacral incisions. They routinely conduct it when vaginal delivery poses a risk to the mother or fetus. Despite being a fairly common procedure and, hence, still relatively safe, Cesarean section is a major surgery and, therefore, requires appropriate planning and recovery.
Cesarean sections are readily available in India with advanced medical infrastructure and expert doctors offering safe perinatal outcomes. A C-section, either planned or performed as an emergency procedure, benefits both the mother and the baby.
What is a Cesarean Section?
Veterinarians perform Cesarean sections to deliver a fetal calf by surgical incision in the maternal abdomen and uterus; they typically perform these procedures under anesthesia and may use them to safely deliver the mother when complications in pregnancy or labor arise.
Veterinarians can plan Cesarean sections and use them as an indication of disease or perform them as a consequence of emergency obstetrical complications during delivery.
Why is a Cesarean Section Needed?
Cesarean section is indicated for many medical and obstetric indications, including:
Fetal Distress:
- Abnormal fetal heartbeat, which may mean there is not enough oxygen for the baby.
- Prolonged Labor: Prolonged Labor:
- Labor that does not progress despite medical interventions.
Placenta Previa:
- Placenta partially or completely occludes the cervix, not allowing for vaginal delivery.
Breech Presentation:
- The doctor presents the baby, in a head-first orientation or otherwise, in a feet-first or in a buttocks-first orientation (rather than head-first).
Multiple Pregnancies:
- Exceeding delivery limits with twins, triplets, or multiple may require a Cesarean section to protect Mother and Child.
Maternal Health Issues:
- Diseases like hypertension, diabetes, or infection that impede vaginal birth.
Previous C-Section:
- Women with a prior C-section may require another due to risks associated with vaginal birth after cesarean (VBAC).
Large Baby (Macrosomia):
- The baby’s size makes vaginal delivery difficult or risky.
Umbilical Cord Prolapse:
- The cord is trapped in the birth canal before the ingress of the infant thereby starving the infant of oxygen.
Types of Cesarean Sections
Planned (Elective) C-Section:
- Outside of routine visit schedules based on documented medical conditions or complications.
Emergency C-Section:
- Administered if acute complications are present during the delivery or labor.
Classical C-Section:
- Surgeons rarely indicate transvaginal hysterectomy trans endometrial vertical incision, except in a carefully selected emergency setting or for extremely preterm delivery.
Lower Segment C-Section (LSCS):
The most widely used one, a horizontal one, on the ventral side of the uterus, facilitates better recovery and reduces the risk of complications.
Procedure Steps
- Pre-Surgery Preparation:
- Medical Evaluation: Laboratory tests and imaging for maternal and fetal screening.
- Anesthesia: Spinal or epidural anesthesia with lower limb block as well as general anesthesia with acute emergency use.
- Sterilization: The abdomen is cleaned and prepared for surgery.
- Incision:
- A subcutaneous horizontal incision is made in the lower abdomen (bikini line) over and into the uterine wall.
- Delivery of the Baby:
- The baby is gently delivered through the incision. The umbilical cord is severed and the baby is handed over to the pediatric team for attention.
- Removal of the Placenta:
- The placenta is removed, and the uterus is cleaned.
- Closing the Incision:
- Uterine/abdominal incisions are sealed with sutures or surgical staples.
- Post-Surgery Monitoring:
- Mother and infant are continuously monitored for vital signs and pain is alleviated.
Benefits of a Cesarean Section
- Safety for Mother and Baby: Reduces risks associated with complicated vaginal deliveries.
- Controlled Delivery: Planned procedures allow for better preparation and reduced stress.
- Prevents Trauma: Avoids birth injuries or complications related to prolonged labor.
- Addresses Medical Conditions: Safe delivery in the presence of maternal complications is maintained.
- Option for Multiple Pregnancies: Safer delivery for twins, triplets, or more.
Cost of Cesarean Section
- United States: $8,000 – $15,000
- United Kingdom: $7,000 – $12,000
- Thailand: $3,000 – $6,000
- India: $1,500 – $4,000
Best Hospitals in India for Cesarean Section
In India, high-tech facilities, secure and cheap, are available for performing C-section delivery. Notable hospitals include:
Metro Hospital Faridabad:
- Renowned for advanced maternal and neonatal care.
- Equipped with modern technology and experienced obstetricians.
Fortis Healthcare (Delhi):
- Known for excellent maternity care and state-of-the-art labor rooms.
Max Healthcare (Delhi):
- Specializes in high-risk pregnancy and gives polyclonal/general pregnancy care.
Risks and Complications
Although the procedure is in general safe, it comes with risks such as:
- Infection: At the incision site or in the uterus.
- Bleeding: Excessive blood loss during or after surgery.
- Blood Clots: Rare but possible in the legs or lungs.
- Reactions to Anesthesia: Nausea, headaches, or other side effects.
- Scarring: Internal and external scars may form.
- Longer Recovery Time: Compared to vaginal delivery.
- Breathing Issues in Newborns: Especially in elective C-sections before 39 weeks of gestation.
Recovery
Immediate Recovery:
- Hospital Stay: Typically 3-4 days for monitoring and pain management.
- First Week: Rest indicates; doctors advise walking to prevent thrombosis.
Long-Term Recovery:
- 6 Weeks: The majority of women finish their recovery within six weeks of surgery, but they should not overexert themselves or lift heavy objects.
- Incision Care: Keep the surgical site clean and dry to prevent infection.
- Follow-Up Appointments: Ensure proper healing and address any complications.
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