1. Maternal aspects: pelvic stenosis obstructs the birth canal; has a history of caesarean section; prenatal bleeding, early placenta previa or placenta dissection; pregnancy induced hypertension or heart disease; genital tract infection. Fetal aspects: fetal malposition; fetal too large, head and pelvis disproportionate; fetal distress, fetal heart sound changes or fetal hypoxia; multiple pregnancy.

2. Preoperative examination: Before operation, a series of examinations should be done, including pregnant women’s temperature, pulse, breathing, blood pressure, past medical history, current physical examination results, blood type, liver function, HIV, hepatitis C and syphilis, in order to determine the health status of pregnant women and fetuses.

3. Preparations for caesarean section: The hospital stay is decided by the doctor according to the condition of the fetus, and the hospital stay is one day before the operation according to the appointed time to prepare for the operation. Dinner before operation should be light and no food should be eaten after 12:00 p.m. to ensure intestinal cleanliness and reduce intraoperative infection. The vital signs were measured before operation, the fetal heart rate was audited, and the fetal heart rate was 120-160 times/divided into normal. Make sure there are no ornaments on your body. Skin preparation, blood collection, catheterization and delivery to the operating room.

4. Disinfection anesthesia: Disinfection ranges from below the sternum to 1/3 of the upper thighs. When choosing epidural anesthesia, anesthesiologists usually insert an epidural tube between the 3rd and 4th segments of the lumbar spine. The drug was released slowly through the tube, and the expectant mother remained awake, but the pain disappeared.

5. Surgery: At the beginning, the doctor will make a 15-20 cm transverse incision in the sagging folds of the lower abdominal wall. The second incision will be in the lower part of the uterus, which can reduce the damage to the uterus and reduce the risk of re-pregnancy. Longitudinal incisions are used only in emergencies. When the amniotic membrane is opened, the fetus and placenta can be removed. Sometimes doctors press the palm of your palm on the floor of your uterus to help the baby give birth.

6. Neonatal management: Dry the newborn and inhale mucus from the nose. The pediatrician will examine him and make APGAR scores to assess his viability, including heartbeat, breathing, reflex, muscle tone and skin color. Weight, length, head circumference, button the first footprint of the newborn, you can hold to his parents.

7. End of operation: Layer by layer suture of uterus and skin for pregnant women, embedding and suturing of wound skin after combination, suture components can be absorbed by human body, from the outside it seems only a thin thread. The wound can heal in about five or six days. If it is not scar constitution, the scar will be like a wrinkle in the skin.

8. Postoperative attention:

(1) The lateral position is adopted to make the body and bed form 20-30 angles, which can relieve the vibration and traction pain of the incision.

(2) Perception recovers after about 3 or 4 hours. You can practice turning over and sitting up. After 24 hours, you can pull out the catheter and get out of bed and move slowly.

(3) Fasting should be avoided within 6 hours after operation, and food intake should be increased gradually afterwards.

(4) Discharge 5 or 6 days after operation, pay attention to vaginal bleeding volume, it will be 1-3 times more than natural delivery, if not timely inform the doctor.

9. Painless childbirth: Pregnant women give birth under epidural anesthesia. But the dosage is much smaller than that of cesarean section. Anesthesiologists inject anesthetics when the uterine opening of a pregnant woman is 3 cm. After anesthesia, the pregnant woman has other sensations besides pain, and can even walk. One or two hours after delivery, the sensation will recover, normal activity can be achieved and discharged from hospital in 2 to 4 days.


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