Cesarean section (C-section) is a surgical delivery method involving an incision in the lower abdomen to access the uterus and deliver the fetus. This procedure is primarily used when natural labor is obstructed or when maternal and fetal health are at risk, ensuring a safe delivery. According to the World Health Organization's recommendations, moderate use of cesarean sections can reduce severe complications, but it is essential to weigh medical necessity against surgical risks.
In modern medicine, cesarean delivery has become a crucial intervention for managing high-risk pregnancies. Its advantages include the ability to promptly address fetal distress, abnormal fetal positions, and other emergencies, but attention must be paid to the potential for longer maternal recovery times due to surgical wounds.
The main categories are "Elective Cesarean Section" and "Emergency Cesarean Section." The former is scheduled before the due date, while the latter is performed urgently due to unforeseen circumstances. The surgery typically involves a transverse incision in the lower abdomen, prioritizing the preservation of uterine integrity.
The surgical process includes: 1. Anesthesia followed by incision of the abdominal muscle layers and uterine wall 2. Direct removal of the fetus and placenta 3. Uterine repair and wound suturing. Modern techniques have adopted minimally invasive methods to shorten recovery periods.
Main indications include:
Other conditions include:
The procedure is usually performed by a team of anesthesiologists and obstetricians. Anesthesia options include spinal anesthesia and general anesthesia. The operation lasts approximately 30-60 minutes, with preoperative assessment and postoperative observation necessary.
There is no "dosage" concept per se, but strict adherence to surgical protocols is essential:
Main benefits include:
Modern technology has improved safety, with uterine suturing techniques reducing the risk of uterine rupture in subsequent pregnancies. For cases of fetal distress, survival rates can be significantly improved.
Short-term risks include:
Long-term risks may involve:
Absolute contraindications include:
Relative contraindications require careful risk-benefit analysis:
Interactions with anesthetic drugs should be carefully considered:
Comparison with other delivery methods:
Multicenter studies show that cesarean section can reduce the rate of severe fetal distress by 70%. WHO statistics indicate that timely execution can reduce maternal mortality to below 0.5%.
Long-term follow-up data suggest the risk of uterine scar pregnancy is about 1-2%, but modern suturing techniques have lowered this rate. Five-year follow-up shows a natural conception success rate of 65-70% post-surgery.
Vaginal delivery remains the primary alternative, suitable for cases where fetal size and pelvis conditions are favorable. Other options include:
Selection should be based on Bishop score and fetal monitoring results, with careful assessment of maternal pelvic conditions and fetal weight by the medical team.
Preoperative assessments include detailed prenatal examinations such as blood tests, fetal monitoring, and uterine position evaluation. The doctor will specify fasting times (usually 6-8 hours before surgery) and check for allergies or chronic conditions. Psychological preparation is also important; discussing the surgical process and potential risks with the medical team is recommended.
What are the pain management options after a cesarean section?Postoperative pain is typically controlled with analgesics (such as opioids or NSAIDs), and epidural analgesia pumps may be used. Non-pharmacological methods include deep breathing, moderate activity, and cold compresses on the wound. Severe or persistent pain or fever should be reported to healthcare providers immediately.
How soon after a cesarean can breastfeeding begin? What should be注意?Breastfeeding can usually start once consciousness has recovered post-surgery. The impact of anesthesia on breast milk is minimal, but monitoring for abnormal reactions such as drowsiness during suckling is necessary. Side-lying positions can reduce abdominal pressure during feeding. If pain medications are used, they should be taken as prescribed to minimize impact on the infant.
What activities should be avoided during the wound recovery period?Within 2-4 weeks post-surgery, avoid heavy lifting (over 5 kg), prolonged standing, or bending to prevent wound dehiscence or uterine prolapse. Showers are permitted but keep the wound dry; sterile dressings are recommended until stitches are removed. Intense exercise should be delayed until after 6 weeks, pending medical evaluation.
What are the risks for women who have had a previous cesarean when they become pregnant again?For women with a prior cesarean, a trial of labor after cesarean (VBAC) can be considered, but assessment of uterine scar thickness and fetal position is necessary. Risks of repeat cesarean include uterine rupture and abnormal placental attachment. Close monitoring during subsequent pregnancies is essential, and scheduled cesarean around 39 weeks is often recommended to reduce risks.
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