There are various methods of childbirth, and cesarean section is one of them. If you are considering giving birth via cesarean section, please review the following information first.
I. The Cesarean Section Process
1. Incision of the Abdominal Wall: After determining the surgical site, the surgeon performs routine cleansing, shaving, disinfection, and anesthesia. An arc-shaped incision is made, followed by sequential layered dissection of the skin and muscle, external oblique muscle, internal oblique muscle, transverse abdominis muscle, and their respective fascias. Blood vessels should be avoided or double-ligated.The peritoneum is then incised. To do this, the surgeon uses forceps to grasp the peritoneum and make a small incision. The surgeon then inserts the middle or index finger of the left hand into the incision. Guided by the left hand, the peritoneum is incised to an appropriate length, exposing the uterus.Retract the uterus: After peritoneal incision, the surgeon's arm should be re-sterilized and rinsed with saline before entering the abdominal cavity to examine the uterus, fetus, and adjacent organs for rupture or adhesions. Subsequently, an assistant should advance the rumen to expose the uterus, gently retracting it beyond the incision. Retraction must be performed slowly and at a controlled angle, as excessive force may cause uterine laceration.After extraction, pack the space between the uterus and incision edges with large, multi-layered sterile gauze to prevent uterine fluids from entering the abdominal cavity and causing infection. 3. Incision of the Uterus: After identifying the greater curvature of the uterine horns, make a single incision through the uterine wall, avoiding the uterine mound. Thoroughly ligate any bleeding points at the uterine wall incision, then carefully dissect the amniotic membranes near the incision.If the membranes are distended with amniotic fluid, make a small incision to drain the fluid first. Choose an appropriate location and direction for drainage. After draining part of the fluid, extend the membrane incision with scissors and evert the edges toward the sides of the uterine incision, securing them in place. This creates a biological barrier with the everted edges, preventing leakage of amniotic fluid into the abdominal cavity and contamination.
4. Extracting the Fetus: Grasp the fetus by the hindfoot or forearm along the uterine incision. Slowly pull the fetus out at the most suitable direction and angle. If the incision is too small, enlarge it. After extraction, the assistant must secure the uterus to prevent it from retracting into the abdominal cavity. Care for the extracted fetus as for a normal calf.
5. Placental Removal: The principle is to remove all detachable portions. If removal is impossible, trim the detached sections and leave the remainder in the uterus to expel naturally. However, the placental membranes near the incision edges must be completely removed and trimmed, as failure to do so will impede suturing.
6. Suturing the uterus: Before suturing, evenly distribute anti-inflammatory powder within the uterine cavity. Uterine closure typically involves two layers of sutures: an initial full-thickness continuous suture followed by a second seromuscular layer suture with submucosal coverage. To accelerate uterine involution, promote hemostasis, and facilitate lochia expulsion, inject 5–10 units of pituitary posterior lobe extract into the uterine cavity prior to suturing.
7. Suturing the abdominal wall: Thoroughly cleanse the abdominal cavity before suturing. After preparing the abdominal incision, first suture the peritoneum using continuous sutures with catgut. Before completing the peritoneal suture, inject antibiotic oil into the peritoneum through the incision to prevent infection and adhesions. Then, perform continuous, layered suturing of the muscles.Finally, close the skin with a mattress suture. When suturing the skin, ensure the wound edges are everted inward; otherwise, wound healing may be impaired, prolonging recovery. After suturing, apply iodine tincture or an anti-inflammatory ointment to the surgical site, then release restraints and assist the patient to stand.
So, when is the optimal time for a cesarean delivery during pregnancy?
II. Optimal Timing for Cesarean Delivery
Compared to infants born at 39 weeks or full term, babies delivered via cesarean at 38 weeks face double the risk of neonatal respiratory and other complications. Infants born between 37 and 38 weeks carry a risk four times higher than those delivered vaginally.
Obstetricians recommend that women opting for cesarean delivery should be mentally prepared and educate themselves about the procedure during pregnancy to ensure a smoother process. Thus, 39 weeks is the optimal time for cesarean delivery.
The above outlines the cesarean delivery process, hoping it proves helpful.