Covers caesarean section as a major operation, beginning with its definition and commonly quoted rates. It then sets out indications grouped as absolute, fetal, labour, maternal and repeat, with a table of urgency categories and decision-to-delivery times. Skin and uterine incision types are described with their advantages and limits, followed by key steps and a table of early and late complications. It closes with vaginal birth after caesarean, its success rate, rupture risk and contraindications, and the effect of repeat caesareans on future pregnancies.
Topic 37 of 61 in the MU Sofia syllabus for Obstetrics and Gynaecology (Dental Medicine, Year 4). The free AceMed note covers it in 6 sections, about 171 words (2 min of reading), with 16 flashcards.
In this note
Introduction
Indications
Types
Steps and care
Complications
Vaginal birth after caesarean (VBAC)
Introduction
Caesarean section is delivery of the fetus through an incision in the abdominal wall and uterus. It is the commonest major operation in women; rates range from 20% to over 40% in many countries.
Indications
Urgency categories
Types
Skin: Pfannenstiel (low transverse; most common, Joel-Cohen technique) or midline vertical (faster access, more room).
Uterus: lower segment transverse (standard: less bleeding, lower rupture risk in later pregnancies) or classical (vertical upper segment: very preterm, transverse lie with back down, large fibroids, accreta, perimortem; high rupture risk later, so no future labour).
Steps and care
Regional anaesthesia, left tilt, catheter, prophylactic antibiotic before the incision, oxytocin after delivery, thromboprophylaxis.
Vaginal birth after caesarean (VBAC)
After one lower-segment caesarean, a planned VBAC succeeds in about 72–75%. The main risk is uterine rupture (≈ 0.5%), higher with induction (especially prostaglandins). It needs continuous CTG and a unit able to do an immediate caesarean. Contraindications: previous classical scar or rupture, placenta praevia.
Each caesarean increases the risk of placenta praevia and accreta in the next pregnancy: the risk of a caesarean continues long after the operation.
Continue reading free
The whole note, all 6 sections, is free with an AceMed account, with its 16 flashcards. Premium adds flashcard recall, highlights and Ask AI.
