30/09/2011

Even never read the Bible know that the fate of a woman is "in the torps to give birth to their children." And it is scary. From fear, a fashionable direction appeared - Caesarean section "At your own request." On the other hand, on the contrary, some refuse to cesarean sections, believing that childbirth should be natural. Who is right?

N. and this question online812 meets the chief doctor of the maternity hospital number 9, Ph.D., Vladimir Atlasov.

Why is the number of women who want without medical testimony so that the child be born with the help of cesarean sections? And even ready to pay for him. Is it correct?
- I believe that this is "your own willing" doctor must listen, because a woman knows, and maybe he feels that it is better for her for her and for a child, if childbirth is completed by the operation. This is the position of not only Russian obstetricians-gynecologists. In many countries, even some European women have the right to choose. But the first on this path went Japan, South Korea, China. In Venezuela, in general, the frequency of cesarean sections reaches 60%.

Now we, in the environment of specialists, are increasingly saying that we must give a woman the opportunity to choose a way to appear her child to light: through labor pathways or surgical incision. If there is some deviation in the child's health state, more precisely, the fetus, or the woman itself, we go to meet her. Because of this, the frequency of the cesarean section is growing. And it is right.

Cesarean section is a surgery, which means risk. Is it possible to provide a woman right to make such a choice? Is it no easier to save it from fears and from those mortwings in childbirth, which are promised forever in the Old Testament? Modern medicine has the opportunity to argue with him ...
- Certainly, the doctor makes a decision on the basis of information obtained from the patient and on the basis of the recommendations of the female consultation. Moreover, as a rule, a woman knows, will know Caesarean, or she will give birth to her. Of course, women will be less configured to surgery if the genera becomes painless. I am here for themselves to solve, give birth in flour or with a painkillers: childbirth - a very heavy test for the body.

There is another opinion: it is necessary to give birth naturally. And actually the childbirth is called the first session of osteopathy, because, passing by the generic paths, the skeleton of the child acquires the form-processed form. In addition, the hard movement "outward" is an important step of adaptation to the outside world ...
- All this fantasy. And if they do not stop them on time, they end the tragedy. Our women "wind" okolomedicine specialists - osteopaths, "fashionable" perinatal psychologists. But it is impossible to confuse official medicine and semi-official, one cannot fall in extremes.

- For example, in Sweden, Cesarean without very serious testimony do not.
- Do, but if any deviation from the recommendations of the doctor take informed consent. For medical or non-medical testimony in England, 26% of the feminine makes a cesarean section, in Italy - 21%, in Finland - 18%. And a relatively small "Finnish percentage" is explained by the fact that the Finns are actively used by vacuum extraction - a modern substitute for forceps that were used with us when the child was difficult. This is also an operational delivery, fraught with complications for a child and for a woman.

- If you do not consider "your own desire," what kind of basic testimony for cesarean sections?
- Indications for Cesarean mainly - from the side of a child who has not yet born. It is explained by the fact that many problems with the intrauterine development of children appeared: chronic placental insufficiency, hypotrophy of the fetus, genetic lesions ... These children are already weak and may not withstand natural labor. And sometimes the woman does not even understand why Cesarean is offered, she feels well, while the child has already broken blood supply, he began to lag in development ...

In our hospital, another frequent testimony for the operation is a scar on the uterus after the previous Cesarean. This is the situation described in the classic obstetrics: "One Caesarean section is always a cesarean section." That is, if the first births passed with Cesarev, then all subsequent pregnancy will be completed by the same operation.

- No matter how many years have passed after the previous one?
- Now there is no regulated deadlines. We believe that after 2 - 3 months, the scar heals completely and the woman can conceive the child and, accordingly, after 9 months to give birth.

- And yet in some maternity hospitals after Cesarean, women give birth to the second time independently ...
- Yes, modern obstetrics allows a woman with a scar in the uterus to give birth through natural generic paths. But in our maternity hospital forbid experiments. For such clans, an individual doctor and individual midwife are needed. One thing is the Institute of Obstetrics and Gynecology. Ot, where 5 - 6 births take out per day, and the other is a city hospital, where at the same time in parents per doctor and one obstetrician 10 feminine. And per day, the medical team takes 30 - 40 childbirth. We work on a staffing schedule approved by the Ministry of Health in 1983, despite the fact that medicine is now different, women in labor and newborns are also different.

- How often do Cesarean in your maternity hospital?
- The frequency of the cesarean section from us - 26 - 27%. For comparison: in Russia - 21%, in St. Petersburg - 22%. But we do not have a typical maternity hospital, we are going to give birth to pregnant with problems. With premature birth, we almost always recommend the operational delivery in the interests of the child - fear of generic injuries.

The frequency of the use of cesarean section is growing, new medical technologies appear, and maternal mortality remains. Why, at the modern level of medicine, women continue to die either in childbirth, or immediately after them?
- Maternal mortality exists all over the world. There are 4 reasons why women die during childbirth or within 1.5 months after them. In the first place - obstetric bleeding, on the second - preeclampsia - the so-called late toxicosis of pregnant women with hypertension, swelling, convulsions, on the third - sepsis, inflammation of the uterus after cesarean or ordinary births, which will slowly progress and the woman can die for 5 to 7 days.

The last, fourth place is in diseases that are not related to pregnancy, but aggravating it, and childbirth, so-called extragenital. Most often it is heart disease, lungs, kidney, liver. In 2009, the main cause of maternal mortality in Russia was swine flu. In Russia, 116 pregnant women died from him, in St. Petersburg - two. To the features of swine flu, struck pregnant women, we were not ready, as, however, the whole world.

- Previously, banned to give birth to women with severe liver diseases, kidneys, cardiovascular system ...
- Modern medicine allows women with these diseases to enter the child. Another thing is that they usually need to make a caesarean section and they are safely allowed and sent with the newborn home. But, unfortunately, in contrast to civilized countries, we do not resemble the katamase - the study of the state of health after delivery.

A woman with congenital heart diseases with the help of doctors endured and gave birth to a child, and what happens to her later when she came out of the maternity hospital? We do not know how she feels herself, whether her heart has grown without lossless, not only the birth (no matter, naturally or through a cesarean section), but also feeding, extinguishing, crazy physical and psychological burden, because of what many suffer from postpartum Depression. We do not even know if she is alive. After all, they give birth now and with very serious diseases - for example, with renal failure.

Abroad, in connection with this, this indicator was introduced as late maternal mortality - the level of mortality among women during the year after childbirth, which is part of the statistics of maternal mortality. And we not only do not enter the statistics, we do not even have such information.

Rosstat gives some figures of maternal mortality, Ministry of Health and Social Development - others. And as a result, when you need to scare someone, some data are used, and when we need to demonstrate the success - others.
- You need to believe the information of the Ministry of Health and Social Development, because they come from hospitals. If a woman died there in childbirth, they do not hide it. And Rosstat receives information from the registry office, which classifies the causes of death on the basis of medical certificates of death. And there often do not indicate childbirth as its cause.

Large lies - data from some regions of the country, in particular, from the Southern and Central Federal Districts. In 2009, 22 women died in the Chechen Republic according to the Ministry of Health and Social Development, and the statistical management of the republic passed the figure - 1. In Astrakhan - 6 women's deaths from 8 were not taken into account by Rosstat. And the Ministry of Health is known, but they are silent there, although in such a situation there should be a thousand checks to send and beat in all the bells.

As a result, according to Rosstat for 2009 (for 2010, official data was not published yet), 388 women died, according to the Ministry of Health - 459: 71, the death case is not taken into account. From here and different indicators: Real - 26 deaths per 100 thousand born women, and for reports on improving the quality of medical care and for comparison with indicators of maternal mortality in developed countries, the Rosstat data is calculated for which we have this indicator at the same level with them - 22 per 100 thousand born.

- What is being done in the city to reduce maternal mortality?
- As part of the modernization program, we will receive new equipment for a total of 10 million rubles. Including the "Selweiver" apparatus for blood reinfusion during obstetric bleeding, which in a number of causes of maternal mortality around the world are in the first place. In addition, we acquire a three-dimensional (3D) ultrasound device, monitors to monitor the state of newborns, the device for artificial ventilation of the lungs, laparoscope and hysteroscope and other equipment. This equipment will receive all the maternity hospitals of the city.

- Is there anything you miss to keep the life and health of women?
- We have everything, you just need to work well. Over the past eight years in the 9th hospital, no feeger died .

On the possible harm of drugs that are used during the cesarean section, as well as the consequences of neglecting the need for a child to go through the generic paths, a lot has been said. But some moms still think that "give birth" on the operating table, thanks to the doctor made a cut in the abdominal wall, easier. Units go to the doctor to ask for a COP. Meanwhile, there are clear indications for Cesarean section on the official list of 2020.

In the territory of the CIS countries, Russia and Ukraine, and Belarus include unified medical protocols, in which absolute and relative testimony are clearly spelled out to be clearly spelled out for the purpose of the cesarean section. In most cases, they relate to situations where natural childbirth carry a threat to the health and life of the mother and the fetus.

If the doctor of the COP recommends, it is impossible to refuse it, because, as they say, all the rules are written in blood. There are states in which Mom itself decides how to give her. This happens, for example, in England. We have no such practice, however, as the laws prohibiting a woman to go under the knife, without explicit testimony.

Moreover, all these readings are conventionally divided into 2 groups:

• Absolute - they are not discussed, since in case of their identification, the doctor simply assigns the day and the operation time. Ignoring his recommendations can bring serious harm to the body of the mother and the baby up to death.
• Relative. Combine cases in which natural labor is still possible, although they can also harm. How to do with relative testimony does not solve a woman, but a consigid of physicians. They weighed everything "for" and "against", necessarily explaining the possible consequences of the future guinea, and then come to a general solution.

And that's not all. There are unplanned situations in which other factors are detected during pregnancy or during childbirth, on the basis of which they can assign an operation.

Absolute testimony from mother and fetus

• Prelation of the placenta. The placenta is a kindergarten. The diagnosis is placed when it covers the entrance to the uterus from the vagina. In childbirth, such a condition threatens the strongest bleeding, so doctors are waiting until 38 weeks and assign an operation. May operate before the bleeding will begin.
• Its premature detachment. Normally, everything should happen after the child's exit, but it happens that the detachment begins even during pregnancy. Due to the fact that it ends with all bleeding, which threatens the life and health of both, is carried out operation.
• The wrong scar on the uterus, which is a consequence of another operation in the past. Under the wrong, the thickness of which does not exceed 3 mm, and the edges of which are uneven with the inclusions of the connective tissue. The data is installed on ultrasound. Caesarean with the scar and in cases, if during its healing, there was an increase in temperature, the inflammation of the uterus, the seam on the skin has long heal.
• Two and more scars on the uterus. It is worth noting that not all women are solved on the natural childbirth after Cesarean because of the fear of the divergence of scars. Doctors can explain the pros and cons of the procedure, but not more. There is an order of the Ministry of Health, according to which a woman can write a rejection of the EP in favor of Cesarean sections, even with a normal scar, and she will have to make an operation. True, the question of the EP is not even put if there were several scars. Even before the start of childbirth, the woman simply operate.
• Anatomical narrowing of the pelvic bone to 3 - 4 degrees. Measure removes the doctor. In such conditions, they can: to move water in advance, to weaken the fight, to form fistula or die fabrics, finally, the kid is able to develop hypoxia.
• The deformations of the pelvic bones or tumors - they can prevent the calm down of the crumbs into the world.
• Digures of the development of a vagina or uterus. If there is a tumor in the field of small pelvis, which closes the generic paths, the operation is carried out.
• Multiple mioma uterus.
• Strong gestosis, non-treatable and accompanied by convulsive seizures. The disease entails a violation of the functions of vital organs and systems, in particular, the cardiovascular, nervous, which can affect the mother's state, and at the state of the baby. With the inaction of the doctors there comes a fatal outcome.
• Scar narrowings of the uterus and the vagina, which appeared as a result of previous births, operational interventions. In such conditions, the stretching of the walls for the passage of the child purses the life of the mother.
• Heavy heart disease, nervous system, diabetes, problems with thyroid, myopia with changes on the eye day, hypertension (it can affect vision).
• The urinary and intestinal fistulas, seams after plastic on the vagina.
• Rip the crotch 3 degree in history (the sphincter, the mucosa of the rectum is damaged). They are difficult to select, besides, it will end everything can incontinence.
• Pelvic preview. In such a state, the risk of generic injuries grows, including injury to the head.
• Cross position of the fetus. Normally, the kid must lie down immediately before childbirth. There are cases when he turns several times, it usually concerns small children by weight. By the way, it is not recommended to give birth even low (weighing less than 1,500 kg). Do you know why? It turns out that in such conditions, the passage of the generic paths is able to surpassed the head or testicles (in boys), which will lead to the development of infertility.
  
• Indication by age. Late pregnancy at primordin in combination with other pathologies. The fact is that after 30 years, women worsens the elasticity of vaginal muscles, as a result of which strong gaps appear.
• Death of feminine. If for some reason the life of a woman does not succeed, doctors fight for her baby. It has been proven that it is able to stay alive for a few hours after the fatal outcome. During this time, the operation should be carried out.
• Threatening uterus break. Its reasons can be like numerous kinds of previously, which thinned the walls of the uterus and large fruit.

Cute moms! Absolute medical testimony should not be regarded by Cesarean, as a sentence, and even more so angry with the doctor. These are simply established circumstances that do not leave him the very choice.

Relative testimony from mother and fetus

There are situations when, making a decision, doctors are advised to and with a woman. Interestingly, in 80% of cases, those agree to operational intervention unconditionally. And the point here is not only in the excitement for the child, although it plays an essential role.

Moms weigh all the "for" and "against", given the qualifications of modern surgeons, the quality of the suture material, finally, the conditions for conducting operations and deliberately try to reduce any risks for no.

List of relative readings to CS:

There are situations when a woman running on natural childbirth is still on the operating table. It happens if problems arise during the process itself.

Indications for emergency operation of cesarean sections

The decision on the operating is taken in the active stage of childbirth at:

• There is no generic activity (if after 16 to 18 hours the neck is slowly revealed).
• The fallout of the umbilical. It can be squeezed, which makes it difficult for the inflow of oxygen to the crumb.
• When detecting hypoxia. In such conditions, during battles, the child may suffocate.

Emergency Caesarean section can also be carried out in other cases that create a threat to the life and health of the girlfriend and her baby.

Note! The campus of the umbilical cord is not a clear indication to the COP, although doctors may offer such a way of guinea. It all depends on the length of the umbilical cord itself, and the type of cordical (tight, non-human, one-time, twofold).

Cesarean sections have not only cons, but also.

Do caesarean cross-section do without indications

In view of the fact that the cesarean section is a serious operation related to a huge risk for mother health, it is never held at will. To dissuade doctors to a woman will not help either fear, nor tears, nor aggravated on the eve of childbirth hemorrhoids.

Everything will pass, it will pass. The main thing, take yourself in hand and give birth. In the end, there are no road!

Around the world, there is a clear tendency to a careful delivery, which allows to preserve health and mother, and a child. A tool that helps this is to achieve is the operation of the cesarean section (COP). A significant achievement was the widespread use of modern anesthesia techniques.

The main disadvantage of this intervention is the increase in the frequency of postpartum infectious complications of 5-20 times. However, adequate antibacterial therapy significantly reduces the likelihood of their occurrence. Nevertheless, there are still disputes about what cases make a cesarean cross section, and when the physiological delivery is permissible.

When the operational delivery is shown

Cesarean section - a serious operational intervention, which increases the risk of complications compared to normal natural genus. It is carried out only on strict indications. At the request of the patient, the COP can be produced in a private clinic, but not all obstetrics-gynecologists will take over such an operation without necessity.

The operation is performed in the following situations:

1. The complete prelation of the placenta is a condition in which the placenta is located in the lower portion of the uterus and closes the inner zev, without letting the child be born. Incomplete preview is an indication for operation when bleeding. The placenta is abundantly equipped with vessels, and even a small damage is able to cause blood loss, a lack of oxygen and fetal death.

2. There was ahead of time from the uterine wall - a condition that threatens the life of a woman and a child. The placenta referred from the uterus is a source of blood loss for the mother. The fruit ceases to get oxygen and can perish.

3. previously transferred operational interventions in the uterus, namely:

• at least two cesarean sections;
• a combination of one COP operation and at least one of the relative readings;
• removal of intertensive or on a solid base;
• correction of the uterine structure.

4. The transverse and oblique position of the child in the uterine cavity, pelvic presence ("boo down") in combination with the expected weight of the fetus over 3.6 kg or with any relative indication for the operational delivery: the situation when the child is located at the inner darkening area , and the forehead (frontal) or face (facial presentation), and other features of the location that contribute to the child's injury.

Pregnancy may occur even during the first weeks of the postpartum period. The calendar method of contraception in the conditions of the irregular cycle is not applicable. Condoms are most often used, mini-saw (gestagne contraceptives that do not affect the child during feeding) or ordinary (in the absence of lactation). Use must be excluded.

One of the most popular methods is. Installation of the spiral after cesarean section can be performed in the first two days after it, but it increases the risk of infection, moreover, quite painfully. Most often, the spiral is set after about a month and a half, immediately after the start of menstruation or in any convenient day for a woman.

If a woman is over 35 years old and she has at least two children, at wishes during operation surgeon can perform surgical sterilization, simply putting the dining of the uterine pipes. This is an irreversible way, after which the conception almost never comes.

Subsequent pregnancy

Natural childbirth after cesarean section is allowed if the formed connecting tissue on the uterus is consistent, that is, strong, smooth, able to withstand muscle tension during childbirth. This question for the next pregnancy should be discussed with a observatory doctor.

The probability of subsequent genera rises in a normal way in the following cases:

• a woman gave birth to at least one child through natural paths;
• if the COP was carried out due to the wrong position of the fetus.

On the other hand, if the patient is at the time of subsequent births for more than 35 years, it has extra weight, concomitant diseases that are inappropriate to each other the size of the fetus and the pelvis is likely that it will again be performed.

How many times can Caesarean cross-section?

The number of such interventions is theoretically not limited, but it is recommended to make them no more than two times to preserve health.

Usually tactics when re-pregnancy as follows: The woman is regularly observed at the obstetrician-gynecologist, and at the end of the service life is made a choice - operation or natural childbirth. With ordinary childbirth, doctors are ready at any time to carry out an emergency operation.

Pregnancy after cesarean section is better planned with an interval of three years and more. In this case, the risk of insolvency of the seam on the uterus, pregnancy and childbirth proceed without complications.

After how much can you give birth after surgery?

It depends on the vastity of the scar, the age of women, concomitant diseases. Abortions after the COP adversely affect reproductive health. Therefore, if the woman still became pregnant almost immediately after the COP, then with the normal course of pregnancy and constant medical supervision, it can endure a child, but the delivery will be most likely operational.

The main danger of early pregnancy after the COP is the failure of the seam. It is manifested by increasing intense abdominal pain, the appearance of bloody discharge from the vagina, then signs of internal bleeding may appear: dizziness, pallor, drop in blood pressure, loss of consciousness. In this case, it is necessary to urgently cause "ambulance".

What is important to know with the second cesarean section?

Planned operation is usually carried out on a period of 37-39 weeks. The incision is made according to the old header, which somewhat extends the operation time and requires stronger anesthesia. Recovery after the COP can also occur slower, as the scar tissue and spikes in the abdominal cavity impede a good cutting of the uterus. However, with a positive man and her family, the help of relatives, these temporary difficulties are completely overcome.

Surgical delivery (cesarean section) are carried out according to the testimony when there is a threat to health and / or mother's life or baby. However, today many of the women in labor due to fear are thinking about auxiliary version of the delivery even in the absence of health problems. Is it possible to Cesarean at will? Is it worth insist on surgical childbirth if there is no indication? Future mom needs to learn as much as possible about this operation.

Newborn baby, which appeared on light by surgical intervention

The COP is a surgical method of a delivery, which assumes the extraction of the baby from the uterus through a cut in the abdominal wall. The operation requires a certain preparation. The last meal is admitted 18 hours before the operation. Before the COP make the enema, conduct hygienic procedures. A catheter is introduced into the bladder patient, and the stomach is necessarily treated with a special disinfectant.

The operation is carried out under epidural anesthesia or under general anesthesia. If the COP is done according to plan, then doctors are leaning towards epiduril. Such a kind of anesthesia suggests that the patient will see everything that happens around, but will lose tactile and pain below the lower back. Anesthesia is done by puncture of the lower part of the back, where the nerve roots are located. Common anesthesia in surgical sorts are used as if time to wait for the actions of regional anesthesia.
The operation itself consists of the following steps:

1. The cut of the abdominal wall. It can be longitudinal and transverse. The first is intended for emergency cases, because it gives the opportunity to get a kid as quickly as possible.
2. Sliding muscles.
3. Incision of the uterus.
4. Opening of the fruit bubble.
5. Removing the baby, and after the placenta.
6. Sushing of the uterus and abdominal cavity. For the uterus, self-sessive threads are used.
7. Outing a sterile dressing. Ice lay on top of it. This is necessary to increase the intensity of uterine contractions and reduce blood loss.

In the absence of any complications, the operation lasts for a short time - a maximum of forty minutes. The baby gets from the mother's lamp in the first ten minutes.

It is the opinion that Cesarean is a simple operation. If you do not delve into the nuances, it seems that everything is extremely easy. Based on this, many women in labor dream of a surgical method of roossession, especially considering which efforts require natural childbirth. But it should always be remembered that the medal can not be one side.

When the CS is obligatory

The attending gynecologist will decide whether the female in the operation needs

In most cases, the COP is planning. The doctor determines whether there are threats to mother and crumbs if the childbirth will be naturally held. Then the obstever discusses the options for the delivery of the delivery. The planned COP is carried out in a pre-designated day. A few days before the operation, the future mother should go to the hospital for the control examination. While the pregnant planning is in the hospital, the doctor monitors its condition. This allows you to predict the likelihood of a prosperous outcome of the operation. Also, the examination before the COP is aimed at determining the consecration of pregnancy: with the help of various diagnostic methods, it is revealed that the baby is ready for birth and you can not wait for the bumps.

The operation has a number of indications. Some factors leave a place for discussion about the method of roostening, others are absolute indications, that is, those in which the EP is impossible. Absolute indications include the states threatening the lives of the mother and the baby in the natural delivery. CS necessarily do at:

• absolutely narrow pelvis;
• the presence of obstacles in the birth paths (moma of the uterus);
• failure of the uterine scar from past CS;
• thinning the wall of the uterus, which threatens it with a gap;
• prelation of the placenta;
• foot prediction of the fetus.

There are relative readings for the COP. These factors are also possible and natural, and surgical labor. The option of the delivery is selected taking into account the circumstances, the health and age of the mother, the state of the fetus. The most common relative indication to the COP is a pelvic preview. With incorrect position, the type of prelation is taken into account, the gender floor. For example, with a butt-foot-foot position, the EP is permissible, but if the boy is waiting, the doctor insists on Cesarean to avoid damage to the scrotum. With relative readings to Cesarean, the correct solution relating to the method of the appearance of a baby to the light can only tell the obstetrician gynecologist. The task of the parents is to listen to his arguments, because they will not be able to evaluate their own risks.

Cesarean can be carried out in an emergency. This happens if the childbirth began naturally, but something went wrong. Emergency COP is carried out if bleeding began in the process of natural output, a premature placental detachment occurred, the fetus has acute hypoxia. The operation is made in an emergency, if the generic activity is difficult due to a weak cutting of the uterus, which cannot be adjusted by drugs.

Elective CS: Is it possible

Happy mom with long-awaited daughter

Is it possible to make a COP at the request of the girlfriend - the question is controversial. Some believe that the decision on the way of the family should remain for the woman, others are confident that only the doctor can choose the optimal method. At the same time, the popularity of elective caesarean is growing. Especially this trend is noticeable in the West, where future mothers actively choose the way of birth of their own baby.

Genuineers prefer surgical childbirth, guided by fear of fasting. In paid clinics, doctors listens to the wishes of future mothers and leave the right to choose. Naturally, if there are no factors in which the COP is undesirable. The operation does not have absolute contraindications, but there are conditions that increase the risks of the occurrence of infectious and septic complications after surgical labor. These include:

• infectious diseases of the mother;
• diseases disturbing blood microcirculation;
• immunodeficiency states.

In the CIS countries, the attitude to the elective COP differs from West. Without testimony, make Cesarean problematic, because the doctor is legal responsibility for every surgical intervention. Some girlfriends, considering the surgical childbirth with a painless way to make a baby on the light, even invent diseases that could serve as relative testimony for the COP. But is it worth the game of the candle? Do I need to defend the right to choose the method of birth of a child? To understand this, the future mother should understand the intricacies of the operation, compare "for" and "against", to study the risks that exist with any surgical intervention.

Benefits of the COP at will

Why many future mothers want to make Cesarean? "Order" the operation of many pushes fear of natural childbirth. The birth of a kid is accompanied by strong painful sensations, the process requires a lot of effort from a woman. Some future mothers fear that they would not cope with their mission and begin to persuade the doctor to cry for them, even if there were no testimony for surgical labor. Another common fear is associated with the fact that the passage of the baby through the generic paths is difficult to control, and the threat to his health or even life may arise.

Fear of EP - normal phenomenon. But not all future mothers can handle it with him. For patients who see in the natural delivery of the mass of threats, the advantages of the "customized" COP are obvious:

An additional bonus is the opportunity to choose the birth date of the baby. However, only this should not push the feminine to insist on the COP, because, in fact, the date does not mean anything, the main thing is the health of the kid.

Reverse side of the "customized" CS

Many future mothers see the caesarean section with a wisdom of a woman anything bad. The operation is represented by him as a simple procedure, where the female inherine falls asleep, and wakes up with the baby in his arms. But those women that pass through surgical labor is unlikely to agree with this. Easy path has a reverse side.

It is believed that the COP, in contrast to the EP, passes painlessly, but it is not true. In any case, this is an operation. Even if anesthesia or anesthesia "turn off" pain during surgical delivery, it returns after. The separation from the operation is accompanied by painful sensations in the seam. Sometimes the postoperative period becomes completely unbearable due to pain. Some women suffer from pain for the first couple of months after surgery. Difficulties arise in the "maintenance" of themselves and the child: the patient is hard to get up, take the crumb into the hands, feed it.

Possible complications from the mother

Why are Cesarean in many countries make solely by testimony? This is due to the possibility of complications after surgery. Complications relating to the female organism are divided into three types. The first type includes complications that may appear after the operation on the internal organs:

1. Big blood loss. At COP, the body always loses more blood than with EP, because when the tissues are cut - blood vessels are damaged. Never predict how the body will react to it. In addition, bleeding is open in pathology of pregnancy, violation of the operation of the operation.
2. Spikes. Such a phenomenon is observed in any surgical intervention, this is a kind of protective mechanism. Usually, the spikes do not show themselves, but if there are many of them, a failure in the work of internal organs may occur.
3. Endometritis. The uterine cavity in the process of operation "Contact" with air. If disaster microorganisms fall into the uterus during surgical delivery, then one of the forms of endometritis occurs.

After the COP, complications on the seams often appear. If they manifest immediately after surgery, they will notice the doctor who made the COP when inspection. However, not always suture complications make themselves know right away: sometimes they are manifested only after a couple of years. Early suture complications include:

Late complications after Cesarean include ligature fistulas, hernias, keloid scars. The complexity of determining such states is that women after some time cease to inspect their seams and can tritely skip the formation of a pathological phenomenon.

• failures in the work of the heart and blood vessels;
• aspiration;
• injuries throat from the introduction of the tube through the trachea;
• sharp decrease in blood pressure;
• neuralgic complications (severe head / spinal pain);
• the spinal block (with the use of epidural anesthesia, strong spinal pain arise, and even the respiratory stop may occur with incorrect puncture);
• poisoning toxins from anesthesia.

In many ways, the emergence of complications depends on the qualifications of the medical team that will do the operation. However, no one is insured against errors and unforeseen situations, so the woman inheritant, insisting on Cesarevo without indications, should know possible threats for its own body.

What may be complications in a child

Caesharita are no different from the babies born naturally

Caesarean section at will (in the absence of testimony) doctors are not taken to carry out due to the likelihood of complications in the baby. The COP is a spent operation to which it is often resorted, but no one has canceled its complexity. Surgical intervention can affect not only the female organism, but also influence the health of the baby. Casarean complications relating to the child may be varying degrees.

With a natural way of birth, the baby passes the generic path, which is stressful for him, but such stress is necessary for the crumb to adapt to the conditions of a new life - out oftobic. With no adaptation, there is no adaptation, especially if the extraction takes place according to the plan before the battle. Violation of the natural process leads to the fact that the kid appears unprepared. It is a huge stress for the rapid organism. COP can provoke the following complications:

• oppressed activity from drugs (increased drowsiness);
• disturbance and heartbeat;
• low muscular tone;
• slow healing navel.

According to statistics, "Caesaryat" often refuse breasts, plus moms may have problems with the amount of milk. You have to refer to artificial feeding, which imposes your imprint on the immunity of crumbs and addictive to the new environment. Children born by cesarean sections are more likely to suffer from manifestation of allergic reactions, intestinal diseases. "Caesaryat" can be lagging behind the development of peers, which is due to their passivity in generic activities. This is manifested almost immediately: they are harder to breathe, suck, scream.

Weigh everything

The COP really actually deserved the title of "Light Rhodework". But at the same time, many forget that surgical labor may have consequences for the health of both "process participants." Of course, the majority of complications at the kid can be easily "removed", if you pay maximum attention to this issue. For example, massage is able to adjust the muscular tone, and if the mother comes to breastfeeding, the immunity of the crumbs will be strong. But why complicate my life if there is no reason for this, and the future mom just lead fears?

Cesarean is not worth doing. Naturally, a woman should have the right to choose, but no wonder this operation is carried out according to the testimony. Only a doctor can determine when it is advisable to contact Kesarean, and when it is possible a natural delivery.

Nature thought out everything itself: the process of childbirth is most prepared by the baby to the extra-utilized life, and at least a large load on the body, but the recovery occurs much faster than after surgery.

When there is a threat to the fetus or mother and the doctor insists on caesarev, the operation is categorically prohibited. The doctor always determines the risks given the fact that it is safer for the life of the fever and the baby. There are situations where Cesarean is the only way to roosity. If the method is subject to discussion, always recommend to grab the possibility of natural labor. The momentary desire to "attach" to avoid pain, you need to suppress. For this, it is enough to talk to the doctor about the possible risks and the likelihood of complications after the operation.

To predict how the COP will be held in each case, one hundred percent is impossible. There is always the likelihood that something will go wrong. Therefore, doctors agitate for the natural childbirth always, when it is possible.

If the future mother itself cannot overcome its own fears associated with the upcoming moment of the appearance of the baby, it can always appeal to a psychologist. Pregnancy is not time for fears. It is necessary to release all bad thoughts, not to go about the momentary desires, and to clearly comply with the recommendations of the gynecologist - starting from the correction of the regime, ending with the method of roostening.

In anticipation of the touching moment of acquaintance with his baby, every woman wants to know the date of birth in advance. This will make it possible to prepare, collect the "alarming suitcase" in the maternity hospital and tune in psychologically. Let's deal with how how many weeks caesarean do.

Cesarean section is planned and emergency. The testimony for it occurs both during pregnancy and during childbirth.

The operation date will depend not only on you, but also from the maternity hospital in which you gathered to give birth. After all, in each clinic its own rules. One completely accurate, make a planned operation with a dead pregnancy or as close as possible to this deadline.

The perfect option, if you have a planned operation. At the same time, mom and kid feel good, nothing threatens their condition. In such a situation, it is possible to perform a cesarean section with the beginning of bouts.

For the baby, this is very good, as the childbirth will begin only when your child is ready for birth and completely matures.

In addition, it will affect positively on breastfeeding.

Such a situation is possible, for example, with eye diseases, the bone system, if the sizes of the mother's pelvis are less than the circumference of the child's head, if the mother in the previous births there were gaps of the rectum, there are tumors of the uterus (mioma), vagina, pelvic bones preventing natural breeds.

In these situations, the planned caesarean section can be performed with the beginning of generic activities for a period of 38-41 weeks. But the female consultation doctor will send you to the hospital in advance, in the period of 38-39 weeks.

It is necessary to pass tests and perform additional surveys if necessary.

In most maternity hospitals, it is preferred not to wait for the start of labor activity, but to schedule the Date Cesarean after the hospitalization of the patient. In this case, you will try to perform an operation closer to 40 week.

By the way, if you like some number, you can ask the doctor to assign an operation for that day. Your wishes will definitely take into account if it is possible.

What week do surgery?

It depends on a specific obstetric situation.

• With a pelvic prevention of the fetus. You are hospitalized in advance, by 38-39 weeks. Weighing everything and against, will take a decision: Cesarean or natural childbirth. If you make a cesarean section, then it is better to wait for the fights. Of course, if there are no other readings so that you do not hesitate with the operation. A child can turn over the head at the last moment and the need for an operation will disappear. Especially if the pregnancy is repeated.
• With the transverse position of the fetus, Cesarean will be made to the appointed date before the start of childbirth. The fact is that when pleasing waters, small parts of the child can fall out - the umbilical cord, handles.
• Full preview of the placenta. The placenta fully overlaps the generic paths. This pregnancy is very difficult to make bleeding due to the danger. With the beginning of the bouts, the neck opens and the bleeding can begin due to the pair of placenta. Therefore, such women operate for 38 weeks. But if the bleeding starts, you will have to perform an emergency operation earlier
• If you have the second caesarean or third and subsequent, then the date of the operation will depend on the state of the scar in the uterus. In the third trimester, the fruit is growing rapidly, and the scar may not withstand the load. If the scar is thinned and overwhelmed, the pain is bolted at the bottom of the abdomen, then wait long will not be. Come on 37 weeks, especially if the third or fourth operation.
• Do not many know that multiple pregnancy It is considered to be dodged in the period of 36-38 weeks. Twin can be given birth through the natural generic paths. But one-time twins, as well as bilayers, when the first child lies booty or across, twins after eco - born by cesarean sections. If the fruits are three or more - only Cesarean. Ease twins are much harder and complications occurs during pregnancy more. Trying to perform a scheduled operation closer to 38 weeks. But, if something goes wrong, one of the children lags behind the other in growth and development, Cesarean can do it earlier, on the 34-35 week, especially if the twin is single.
• HIV-infected Women are closed in a planned manner for 38 week.
• After cervical operations You are also waiting for a planned caesarean section, before the start of childbirth. It is necessary that the neck is not damaged when the contractions begin.

When do Emergency Caesarean?

Indications for emergency cesarean cross section may occur on any period, even with premature pregnancy, i.e. Earlier 37 weeks. If, in the period from 28 to 34 weeks, childbirth begin, or indications for the birth of a child before the deadline, then the cesarean section is performed. The child is not mature and childbirth through natural generic paths for him too complicated test.

Emergency Caesarean section performs up to 37 weeks, if:

1. Bleeding begged due to premature placental detachment.
2. Bleeding in the preservation of the placenta.
3. With the appearance of signs of breaking the uterus in the head. Especially if the scar in the uterus is not alone.
4. Another reason is the hypoxia of the fetus. The child is missing nutrition and oxygen from the mother. If such a state continues for a long time, the baby may die. To save the child, and it is necessary to give birth and nail it in a cuvez, even if the pregnancy term is still small.
5. If from 22 weeks of pregnancy you are tormented by swelling, high pressure, bad urine tests are precipation. With an increase in the term of pregnancy, heal him becomes more difficult, the child also suffers from mom's edema and lags behind in growth. If the state of the woman and the fetus deteriorates sharply, they perform caesarean on any time.

Caesarean section can do in childbirth that will begin on their own.

• Clinically narrow pelvis - When the sizes of the mother's pelvis and the size of the preserving part of the child do not correspond to each other and the childbirth is impossible. This is clearly becoming only in childbirth.
• Frontal prediction - When the head enters the small pelvis the largest size. Her birth through natural generic paths becomes impossible.
• Pupli loop loss After influencing the accumulating waters.
• Hypoxia The fetus can develop during childbirth. In this case, childbirth must be completed immediately so that the child does not suffer.

There is also a small caesarean section. It is performed on the period of pregnancy 13-22 weeks to interrupt its purpose. It is performed if the placenta fully overlaps the entrance to the uterus. Or there is a detachment of placenta and bleeding, which requires emergency assistance to a woman.

As you can see, the testimony for the cesarean section can be the most different and arise on any time and at any time. Therefore, as soon as you leave on the decret, collect an "alarming suitcase", which will have everything you need for you and baby.

Fetal passport and your passport, shirt, bathrobe, spoon, mug, personal care products: calcination, gaskets, toothpaste and brush, toilet paper, gel for intimate hygiene or soap. For kid diapers, powder, pelleys, suites.

What time it would not be done by Cesarean, the main thing is that this is done according to the testimony and retained the health of the future mother and the child.

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In recent decades, more and more often, kids are born with the help of a cesarean section (COP). In some Roadmas CIS countries, the COP frequency indicators reach 50% of all kinds. In 2005, WHO conducted studies that showed that the frequency of antibiotics prescribes in the postpartum period increases with an increase in the CS frequency, the level of maternal morbidity and mortality increases. On average, the cesarean operation surgery accounts for 15 genera from 100, while further increase in the frequency of the COP does not lead to a decrease in perinatal morbidity and mortality in children.

Considering the high frequency of the COP, any possibilities to reduce the risks associated with the operational delivery will have significant advantages both for individual fevering and in terms of economic costs.

Compared to natural genus Maternal mortality rates for CS (40 per 10,000 cases) 4 times higher than for all types of vaginal delivery, and 8 times higher than for normal vaginal genera (5 out of 10,000 cases).

Planned caesarean section

The cesarean section operation can be carried out when the doctor together with the female has decides in advance about operational childbirth, as the safest method of the delivery, or is emergency when indications arise to an urgent operational delivery. While registering an obstetrician-gynecologist collects a history of pregnant. Based on this information, he decides on the form of a rapid proposal recommended by this woman. Indications for a planned caesarean section can be both from the mother and from the fetus.

These include the following states:

From the mother:

The prevention of the placenta, which is confirmed by an ultrasound study after the 36th week of pregnancy (the edge of the placenta is less than 2 cm from the inner session);

Scar in the uterus in the presence of contraindications to subsequent vaginal childbirth:

• The presence of any contraindications to vaginal childbirth;
• Previous corporate ks;
• Previous T and J-shaped incision on the uterus;
• Uterine breaks in history;
• Any previous reconstructive operations in the uterus, resection of the angle of the uterus, hysterotomy, momectomy with the penetration of the uterine cavity in history, laparoscopic momectomy in the absence of inventing the uterus with modern suture materials;
• More than one COP in history. As an exception, vaginal labor is allowed in women who have undergone 2 COPs, if there are at least some vaginal genera in history;
• Failure of a woman from attempting vaginal childbirth;

HIV-infected women:

• women taking three antiretroviral drugs and having a viral load over 50 copies of 1 ml;
• women taking monotherapy assvudin;
• Women infected with HIV and viral hepatitis with at the same time.

in such cases, the COP is shown on the period of 38 obstetric weeks, to the rupture of the fetal shells;

The appearance of first genital herpes for 6 or less weeks before childbirth;

The presence of extragnenital pathologies (the diagnosis must be set or confirmed by a specialized physician):

• from the side of the cardiovascular system - arterial hypertension of the III degree, the coarcation of the aorta (without operational correction of vice), aortic aneurysm or other large artery, the systolic dysfunction of the left ventricle with the emission fraction
• ophthalmic - hemorrhagic form of retinopathy, perforated corneal ulcers, wound an eyeball with penetration, "fresh" burn. Other pathology of the bodies of vision are not indicated to the COP;
• pulmonological, gastroenterological, neurological pathologies, under which the attending physician recommends childbirth through the COP;
• Tumors of the small pelvis organs or the consequences of the pelvis injury, preventing the birth of a child;
• Cervical cancer;
• States after the rupture of crotch III degree or plastic operations on the crotch;
• States after the surgical treatment of urinary and intestinal-sexy fistulas;

From the fetus:

• Pelvic prevention of the fetus for a period after the 36th week;
• Pelvic presence or improper position of the fetus for multiple pregnancy;
• Transverse preservation of the fetus;
• Monoamniotic twins;
• Syndrome of the growth delay of one of the fruits in multiple pregnancy;
• Gastroshisis, diaphragmal hernia, spina bifida, a teratom of the fetus, the fighting of twins - subject to the possibility of providing operational assistance to the newborn child;

COP at the request of a woman in the absence of listed readings is not conducted. On this occasion in medicine there are discussions. On the one hand, women want to independently decide which way to give birth to a child, and on the other, Cesarean section is an operation and conjugate many risks for the mother and fetus. In case of failure of a woman from the shown operation, it must sign an informed refusal to sign.

Terms of execution of the planned cesarean section

Perform after complete obstetric 39 weeks of pregnancy. This is due to the minimization of respiratory distress syndrome (RDS) in a newborn.

In the case of multiple pregnancy, the planned COP is performed after 38 weeks.

In order to prevent the vertical transmission of the disease in the HIV-infection of the mother - in 38 weeks of pregnancy, before the fattening of the oily water or before the start of the generic activity.

With a monoamniotic double, the COP operation must be performed on a period of 32 weeks after the prevention of the Fetal RDS (special injections are made that contribute to the disclosure of the lungs).

Our life is changing every day. And medicine, and science develop rapidly, saving and facilitating life with the help of new technologies. We are delivered from many who existed earlier, problems. But the main thing is not changing - we continue to love, hope, give birth and educate children. In our life, the child's child is always the most amazing and significant event.

Pregnancy - physiological process, not a disease, argue many doctors. However, during this period of life, women's health is checked for strength, it needs to go through increased loads, which makes it more sensitive and wounded. Childbirth is also not a pathological condition, but the necessary difficult process, which ends with the birth of the kid. But it is a huge stress for both and sometimes requires special medical intervention.

There is no general opinion among the doctors about the only right, safe and most painless way of childbirth, especially for healthy women with normal pregnancy.

an exemplary woman has the right, and now the opportunity to choose the best and most secure and child for himself the option of the delivery, selected together with its observing physician and approved by him in accordance with all the testimony that has arisen during pregnancy.

But there are situations where an obstetrician gynecologist definitely or weighing risks insists on holding a cesarean section - a surgical operation that allows the child to appear by extracting it from a mother's belly that cannot or can not be given by it in the usual way.

Causes of increasing the frequency of cesarean section

Increasing the number of women who decided to give birth only after 30 years in combination with possible gynecological pathologies (adnexitis, endomyometritis, neuroendocrine disorders, infertility, operations in the uterus and appendages, the mioma of the uterus, endometriosis, etc.).

The frequent course of pregnancy against the background of various other non-gynecological diseases, when pregnancy proceeds with complications. Often there is a complicated childbirth.

Improving the diagnosis of pathology during pregnancy at the expense of new research methods to establish a more accurate diagnosis.

Expansion of testimony for cesarean section with severe gestosis, premature pregnancy, the pelvic preservation of the fetus.

Expansion of testimony for cesarean section performed in the interests of the fetus.

The ability to avoid the imposition of obstetric tongs.

Most of the pregnant women who previously undergoing Cesarean, which is not recommended to give birth independently.

Despite all these reasons and testimony, specialists in one vote recommend that if there is an opportunity to give birth on their own, then no matter what a cesarean section of speech should not go, because the risks for both the mother and for the child with a cesarean section are not lower, but Often higher than with natural childbirth.

Indications for Cesarean section

Kesarean section has to resort when pregnancy proceeds with complications and natural labor becomes dangerous. Well, if the obstacles are detected long before delivery, then the doctor can plan the operation in advance and prepare a fever. In this case, Cesarean section is called planned. But sometimes it happens that the woman begins to give birth normally, but something happens not so and the situation becomes dangerous. In this case, the emergency operation is carried out.

Caesarean section is carried out exclusively by appointing a doctor. Well, if the future mother weighs all "for" and "against" and turn to several specialists. As a rule, pregnant women are offered artificial delivery for several reasons. The indications for the planned caesarean cross section may be the following.

Indications for a planned operation

For these reasons, during pregnancy, the doctor can schedule Caesarean sections:

Indications for emergency cesarean section

These are any complications during childbirth that violate their normal moves and threaten the lives and state of health mom and baby.

Anesthesia methods for cesarean sections

There is a general (endotracheal) and regional (epidural or spinal anesthesia) anesthesia methods for cesarean sections.

Endotracheal anesthesia immerses the harmonic to a medical sleep, and the anesthesia is carried out in the respiratory trachea (trachea) through the tube. Therefore, it is called endotracheal. Entitful anesthesia is faster, but after awakening it often causes unpleasant consequences: nausea, pain in shoulders, burning, drowsiness.

With the "epiduril" makes an injection in the spinal channel. Only the bottom of the body is anesthetized. During the operation, the fever is in consciousness, but does not feel pain. To see the whole process does not have to - health workers will hang at the chest level of a pregnant special screen. After the anesthesia worked, the doctor gently cuts the abdominal wall, then the uterus. The crumb is taken out after 2-5 minutes. As soon as the baby was born, mom can see him and attach to his chest. Epidural operation lasts about 40-45 minutes and, first of all, suitable for mothers who are experiencing that under anesthesia they will not be performed by their "participation" in childbirth and will not be able to see their first kids ...

Consequences of Cesarean section

Cesarean section increases the risk of serious problems with anesthesia, infection and bleeding. It will take a longer hospitalization. Pains appear after a week after childbirth and difficulties in care for the newborn and other children, will need more painkillers, antibiotics and blood transfusions are more likely than after childbirth through natural ways. It is not so soon possible to return to home responsibilities or to work. Moreover, financial expenses are much larger than with natural childbirth.

Children born by a caesarean cross section have more problems with breathing and maintaining temperature, especially if there were no fights at all. Even compared to long-term or difficult births through natural paths, this additional risk exists.

By making a decision regarding the cesarean section, you with your doctor must weigh the risk and advantages. The risk of cesarean sections pays off only in situations where childbirth through natural ways can create even greater risk for a mother or child.

Cesarean section, called yet "Roman kinds", is an operation, during which the woman is cutting the abdominal cavity and the wall of the uterus, after which the child and the last are removed. The reasons for such a transaction can be a variety of factors, but at what date the planned caesarean is done, solves the attending physician.

The planned caesarean section is usually not done earlier than 38 weeks of pregnancy, as it is believed that, starting with this period, the child becomes viable. In rare cases, the planned caesarean can be appointed earlier than 38 weeks of pregnancy, which is associated with the factors, due to which the guinea cannot wait for the fights and live. In any case, the woman passes a special preparation for the operation, which will reduce the operational risks and simplifies the postoperative period.

Causes of destination Kesarean

A planned caesarean section is appointed in cases where natural childbirth is dangerous due to a high degree of threat of life and health for a guinea or infant.

Causes of the impossibility of natural delivery:

Sometimes the planned caesarean section is prescribed due to the combination of two or more factors.

When should I go to the hospital when appointing planned caesarean?

While the observation lasts, the doctor, relying on the factors impeding the conduct of natural childbirth, pronounces with the patient the need to fulfill the planned caesarean section, no one does from this. Moreover, the doctor will thoroughly explain the reasons for which Kesarean is appointed, how much the operation will continue, will discuss the preparation and timing of it.

If the pregnancy proceeds normally, the patient comes to the maternity hospital for a period of 36-37 weeks, then observed from specialists, and if the testimony for operation is still present, an operation is carried out on the period of 38-39 obstetric age weeks.

In the case when there is a threat of interrupting pregnancy, the patient is sent to the hospital for a period of 33-34 weeks or earlier if there is a need. The factory aimed at preserving pregnancy is appointed in the maternity hospital, and then the operation is also carried out for a period of 38-39 weeks.

In exceptional cases, the planned operation can be appointed for a period of 36 weeks. This happens when the patient, due to various circumstances, it is impossible to wait for kits.

Operation

Anesthesia used during Cesarean:

• Epidural anesthesia - anesthesiologist is introduced an anesthetic substance into the epidural area of \u200b\u200bthe spine, as a result of which the temporary blockade of nerve endings occurs, and the patient does not feel pain from the operation, but is conscious and can see and hear his newborn baby.
• The spinal anesthesia is similar in action with epidural, the main difference is that an anesthetic is introduced into the spinal spinal area and causes the blockade of the spinal cord.
• General anesthesia - in current medicine, it is used as a certain exceptional measure when the patient has intolerance to local anesthesia. Such anesthesia affects the born baby, it is sluggish, sleepy, in addition, under the influence of general anesthesia, a woman is devoid of opportunity to immediately see his baby, hear his first cry.

During the operation, the fabrics of peritoneum and uterus are cutting horizontally, remove the baby and cut the umbilical cord. Then the baby is washed, removed from the nose and mouth mucus and the residues of the octoped water. In the meantime, remove the last, overlap several seams and completed the operation. The duration of the operation on average is about half an hour. Since there are no need for planned operations with viable babies, it is usually no need to put them in the kuvez.

Then the woman stays in the postoperative ward under observation during the day. It is prescribed to the painkillers and the medicine-cutting uterus, as well as the introduction of bloodstream solutions, which ignite the blood loss that occurred during the operation.

With the normal course of the postoperative period, the patient is transferred to the postpartum separation, where it is already in conjunction with the baby. A few days later, they make painkillers and cutting injections, observed for the state of the seam, processing it daily by antiseptics.

Postoperative period

How much fever will be in the maternity hospital after the operation, solves the attending physician who is observing its condition. As a rule, for the 5-7th day, a woman is discharged home. It is prescribed a special diet to restore normal intestinal functions, two-month sexual rest and refusal to physical exertion for up to six months.

Complications related to the operation:

After the operation, the doctor prescribes several ultrasound studies, the first of which is two months after the operation.

Ultrasound will show how the healing of the seam and the restoration of the operated regions. It is believed that in 2-3 years, the female organism passes after the operation, and the subsequent pregnancy is better planning a minimum of 3 years after Cesarean.

Observing the prescriptions of the doctor, as well as regularly visiting the gynecologist for the seam inspection, the woman minimizes all possible risks and complications associated with the cesarean operation.

Caesarean section can be emergency and planned, that is, conducted in the timely installed time or before that time, and even a woman at all, which has not been planned. What to expect from the operational delivery? How to prepare a woman? What is the difficulty of restoring the body after surgery? And what scheduled caesarean section has causes for conducting?

Usually about a possible operation, if there are any reason to it, a woman will know in advance, a few weeks before the alleged start of the beginning of the generic activity, from a female consultation doctor leading her pregnancy. However, there will be an operation or not, the question is not solved. And the doctor does not discharge the direction to the hospital so that his patient was planned. From a doctor leading pregnancy, only the direction in the maternity hospital is required, namely, in the department of pregnancy pathology. The question of the operation, its need, the timing, anesthesia is accepted directly by the doctors of the maternity hospital.

Usually, the planned caesarean make on the period as close as possible to the estimated date of birth. But without special testimony not on weekends or holidays. This is especially true in the conditions of small maternity houses of small towns, where there are no constantly on duty in the maternity hospital of the anesthesiologists.

Upon admission to the pathology of pregnancy, a woman is carefully examined. Let even in front of hospitalization already handed over urine and blood tests, it defies everything. In addition to general analyzes, it takes blood from Vienna on HIV, RW (syphilis), hepatitis, biochemical analysis, sugar, blood group and a rhesus factor. On a large period, especially with low arterial pressure, in the morning, an empty stomach, when donated blood from Vienna, a woman can become bad. If you have already been not good during blood, ask the medical sister to make her fence in you in the lying position, on the couch. And immediately after eat a piece of chocolate. He will quickly return to you vigor.

Preparations for the planned caesarean also includes bypassing different doctors. Necessarily an oculist, therapist, otolaryngologist. The day before the operation, the ECG is performed. There is a conversation with anesthesiologist. If hospitalization is carried out a few days before the operation, a woman can make droppers with saline. It is necessary to saturate the body with liquid, because with operational intervention, a large blood loss is expected. This liquid will go to its replenishment. In addition, the women make intravenous injections of Piracmetam - a drug that improves brain blood supply.

In the evening, before surgery, a woman is consumed. Cleansing the intestines are carried out again in the morning. Put the catheter in the bladder. Well, further, the work of doctors and honey. sisters. The way the Operation of Planned Cesarean is being passed - how successful, depends on them, and from the individual features of the health of the female in labor and the flow of its pregnancy. Woman make spinal (epidural) anesthesia or endotracheal (general) anesthesia. The incision of the peritoneum is usually performed in the lower stomach segment, transverse, less often vertical. The second heals worse and gives more complications. Therefore, it is performed only when it is carried out, especially with premature pregnancy, or planned, but with the life-threatening life of the guinea or child. It is bad that type of incision of its inesthetics and long healing. This not only reduces the quality of the life of a woman in the first months after the operation, but also negatively affects the occurrence of the next pregnancy. So, complications after the planned caesarean section in the form of an insolvent scar in the uterus, in the case of a horizontal cut, is a rarity. True, not only the type of cut, but also the operation and the postoperative period plays.

Thus, the following are issued pros and Cons Planned Cesarean.

• no generic pain;
• there is no fear for the fact that the child will have a generic injury;
• no crotch breaks, cervix.

• long, healing of seams and problems in the form of hernia and other surgical complications;
• problems with the establishment of breastfeeding (due to the late application of the child to the chest and its rare sucking);
• often developing endometritis (inflammation of the uterus), requiring treatment with antibiotics - common consequences of the cesarean section;
• possible discrepancy between the Oblats during the next pregnancy;
• postoperative pain;
• the need to use contraception, pregnancy planning no earlier than two years after surgery.

Indications for the planned caesarean section and the timing of its implementation

The reasons why doctors can solve to work out a woman, quite a lot. This is only some of them, the most common.

1. Clinically narrow pelvis. This is the case when there is a very strong sense of its narrowing. The doctor clearly understands that the child can not be born independently. But more often a certain narrowing of the pelvis is diagnosed, in which it is still possible to give birth to a small child.

2. High degree of myopia (myopia). The question of the operation is solved after the consultation of the ophthalmologist. It often happens that a woman is still allowed in natural childbirth, but using epidural anesthesia and try to reduce the sweep period as much as possible.

3. The threat of the discrepancy of the scar in the uterus. What time is the planned caesarean section, and how it passes, depends on the viability of the scar on the uterus, that is, its thickness all over. If there is a suspicion of its inconsistency, the operation can be transferred to earlier deadlines, 37-38 weeks.

4. Pelvic presence of the fetus or other, not head. The planned fetus is done if the woman is entering the boy. Fortunately, modern ultrasound devices make it possible to be almost unmistakable determination of the sex of the child. Or if the kid weighs more than 3.5 kg and the woman is primary. Girls can give independently to give birth to women repeatedly, if the weight of the child is less than 4 kg, and in the maternity hospital there is an opportunity to conduct an emergency operation. The transverse position of the fetus is an absolute indication for the operation.

5. Symphyzit. A planned caesarean section in 39 weeks or even earlier in this pathology. Depends on the degree of divergence of bones of the pelvis of a pregnant woman and her well-being. With a pronounced symptite, independent childbirth is contraindicated. The exact diagnosis is made on the basis of ultrasound data.

6. Untezzlement of generic activities, despite the "stimulating" therapy. Sometimes it happens that the fetal has already appeared signs of "overrearness", there is reason to believe in him hypoxia, the accumulate waters are not enough, but the childhood does not begin. Then, especially if a woman over 28 years old and gives birth to the first time, doctors can recommend a future mother to be resolved from the burden of operational way. What week do the planned caesarean cross section in this case? Usually adverse signs of transferred pregnancy appear in 41-42 weeks. That is, the deadlines for the operation are individual.

7. Some cardiovascular diseases, heart defects. If a woman is generally a good pregnancy, in the hospital she can be offered to hospitalize directly at the beginning of a generic activity, or when as a result of the inspection of the cervix, it becomes clear that independent childbirth is about to begin. What time is the scheduled - you ask? At the most closely close to the beginning of natural labor. After all, otherwise, it remains a high probability of difficulty with adaptation to the external environment in the fetus. Sometimes even the dead children who appeared on the light of cesarean sections, but prematurely, there are problems with independent breathing. That is, often scheduled second caesarean makes about 40 weeks for a period of about 40 weeks, when fermented waters depart, or a woman begins to feel grapple-shaped pain.

Less often, the reasons for the operation becomes varicose expansion in the vagina region, expressed by hemorrhoids (there is a chance of thrombosis of nodes).