Cesarean section (C-section) is a surgical method of delivering a baby by removing the fetus through an incision in the abdomen and uterus. It is primarily used when natural delivery is not feasible or presents high risks. This procedure involves making incisions on the abdominal wall and uterus to extract the baby, effectively reducing maternal and neonatal injuries caused by difficult labor. Its core purpose is to provide a safe alternative delivery route when maternal or fetal health is threatened, especially in emergency situations such as fetal distress, abnormal fetal position, or obstructed birth canal.
Cesarean sections are classified into "Elective Cesarean" and "Emergency Cesarean." Elective procedures are usually performed after 39 weeks of pregnancy, while emergency procedures are carried out due to sudden issues during labor. The surgical process involves general anesthesia or epidural anesthesia, followed by a transverse or vertical incision on the lower abdomen, opening the uterine wall to deliver the fetus, and finally suturing the uterus and skin. This approach bypasses the natural dilation of the birth canal, directly resolving delivery obstacles caused by narrow passageways or fetal size incompatibility.
Indications include fetal heart abnormalities, abnormal fetal position (such as breech), previous uterine surgery scars, placental abruption, or umbilical cord prolapse. Additionally, obstetric complications such as eclampsia, poorly controlled gestational diabetes, or severe narrowing of the birth canal that pose high risks for natural delivery may warrant this procedure. Multiple pregnancies or subsequent pregnancies after previous cesarean deliveries may also be considered indications.
The procedure typically requires hospitalization, with fasting for 6-8 hours beforehand and blood tests performed. Anesthesia choice depends on patient condition, opting for general or epidural anesthesia. The surgery lasts approximately 30-60 minutes. Postoperative monitoring includes bleeding, infection, and uterine recovery, with hospital stay generally lasting 3-5 days. The concept of dosage does not apply, but anesthetic drug doses are adjusted based on weight and health status.
The main advantage is the immediate resolution of delivery crises, especially when fetal hypoxia or maternal bleeding occurs, allowing for critical intervention time. Compared to natural delivery, this surgery avoids perineal tears and is suitable for patients with a history of uterine rupture or severe obstetric complications. Moreover, elective cesarean allows families to plan delivery timing in advance, enhancing psychological preparedness.
Short-term risks include uterine bleeding, infection, anesthesia complications, and injury to internal organs. Long-term sequelae may involve uterine scar pregnancies or increased risk of uterine rupture in future pregnancies. Neonates may experience respiratory issues due to lack of passage through the birth canal, and mothers may have prolonged recovery due to surgical trauma.
Contraindications include severe risk of uterine rupture, significant coagulation disorders, or severe uterine structural abnormalities. Preoperative assessment must confirm no severe infections or uncontrolled ectopic pregnancy. Postoperative care requires strict adherence to recovery guidelines, avoiding premature weight-bearing or contact with contaminants to prevent infection spread. Patients with diabetes or cardiovascular diseases require special risk assessment.
If the patient has a history of uterine surgery or is on anticoagulants, anesthesia and hemostasis plans need adjustment. The use of labor-inducing agents (such as oxytocin) must be cautious; failure of induction may necessitate conversion to cesarean. Long-term, choosing cesarean may affect future attempts at natural delivery (VBAC), which should be discussed with the healthcare provider regarding subsequent reproductive plans.
Global data indicate that cesarean delivery significantly reduces the mortality rate of severe delivery complications, with success rates in emergency situations exceeding 98%. Studies show that elective procedures can reduce fetal distress risk by up to 70%, but repeated surgeries increase the risk of uterine rupture by 2-3%. Clinical guidelines recommend that when indications are clear, the benefits outweigh the risks.
Natural delivery remains the first choice, with induction or fetal position correction (such as external cephalic version) potentially avoiding surgery. Water birth or episiotomy can improve some obstetric issues, but are limited in cases of fetal distress or uterine abnormalities. Non-invasive monitoring techniques (such as fetal monitors) assist in deciding whether to proceed to cesarean, but final decisions should be based on real-time medical assessment.
Uterine ligament stretching may cause unilateral lower abdominal pain. It is recommended to apply ice packs within 24 hours post-surgery to reduce swelling, and after 48 hours, switch to warm compresses to promote circulation. Doctors may prescribe NSAIDs, but avoid lifting heavy objects or vigorous activity too early. If pain persists beyond two weeks, consult your physician to check for infection or other complications.
What dietary restrictions should be followed during recovery?It is advisable to avoid high-fiber foods (such as whole grains) to reduce the risk of intestinal adhesions, and avoid raw fish or sashimi to prevent infection. Start with liquids or semi-solid foods initially, gradually adding high-protein diets to promote healing. Diabetic patients should control refined sugar intake to maintain blood sugar stability.
When does numbness from epidural anesthesia typically resolve?About 90% of patients regain sensation within 2-4 hours after surgery. Persistent numbness beyond 6 hours accompanied by muscle weakness may indicate nerve compression. Neurological tests will determine if intervention is needed. Full recovery usually takes 1-2 weeks; during this period, avoid walking alone to prevent falls.
What are key steps in caring for a cesarean scar?Within 72 hours post-surgery, keep the scar covered with sterile gauze and change daily. After the seventh day, use scar prevention patches. During the scar maturation period (within 6 weeks), avoid contact with alcohol-based cosmetics, and consider using medical-grade silicone gels containing vitamin E. Signs of infection such as redness, swelling, heat, pain, or pus require immediate medical attention.
What is the minimum safe interval for pregnancy after a cesarean, and what risks should be considered?The World Health Organization recommends waiting at least 18-24 months before conceiving again to allow proper healing of the uterine scar. Shorter intervals may increase risks of placenta previa and uterine rupture. During pregnancy, ultrasound at 12 weeks should confirm scar healing, with weekly monitoring of lower uterine segment thickness from 18 weeks until 24 weeks.
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