Cesarean
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Cesarean
Caesarean section, also known as C-section or caesarean delivery, is the Surgery, surgical procedure by which one or more babies are Childbirth, delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or mother at risk. Reasons for the operation include obstructed labor, twin pregnancy, pre-eclampsia, high blood pressure in the mother, breech birth, and problems with the placenta or umbilical cord. A caesarean delivery may be performed based upon the shape of the mother's pelvis or history of a previous C-section. A trial of Vaginal birth after previous C-section, vaginal birth after C-section may be possible. The World Health Organization recommends that caesarean section be performed only when medically necessary. Most C-sections are performed Caesarean delivery on maternal request, without a medical reason, upon request by someone, usually the mother. A C-section typically takes 45 minutes to an hour. It may be done ...
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Vaginal Birth After Previous C-section
In case of a previous caesarean section a subsequent pregnancy can be planned beforehand to be delivered by either of the following two main methods: * Vaginal birth after caesarean section (VBAC) * Elective repeat caesarean section (ERCS) Both have higher risks than a vaginal birth with no previous caesarean section. There are many issues which affect the decision for planned vaginal or planned abdominal delivery. There is a slightly higher risk for uterine rupture and perinatal death of the child with VBAC than ERCS, but the absolute increased risk of these complications is small, especially with only one previous low transverse caesarean section. 60–80% of women planning VBAC will achieve a successful vaginal delivery, although there are more risks to the mother and baby from an unplanned caesarean section than from an ERCS. Successful VBAC also reduces the risk of complications in future pregnancies more than ERCS. Technique Where the woman is labouring with a previous secti ...
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Childbirth
Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globally. In the developed countries, most deliveries occur in hospitals, while in the developing countries most are home births. The most common childbirth method worldwide is vaginal delivery. It involves four stages of labour: the shortening and opening of the cervix during the first stage, descent and birth of the baby during the second, the delivery of the placenta during the third, and the recovery of the mother and infant during the fourth stage, which is referred to as the postpartum. The first stage is characterized by abdominal cramping or back pain that typically lasts half a minute and occurs every 10 to 30 minutes. Contractions gradually becomes stronger and closer together. Since the pain of childbirth correlates with contractions ...
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Caesarean Delivery On Maternal Request
Caesarean delivery on maternal request (CDMR) is a caesarean section birth requested by the pregnant woman without a medical reason. Background The concept of "Caesarean delivery on maternal request" (CDMR) is not well-recognized in health care, and consequently, when it occurs there are no mechanisms in place for reporting it for research or distinguishing it in medical billing. Over the last century, delivery by Caesarean section (CS) has become increasingly safer; the medical reasons, therefore, for selecting a CS delivery over a vaginal birth are less likely to be those of necessity, and more likely to be motivated by other factors, such as considerations of pain in vaginal delivery and the effects of childbirth on vaginal muscle tone. Until recently, an elective caesarean section was done on the basis of medical grounds; however, the existence of CDMR makes the mother's preference the determining factor for the delivery mode. An elective Caesarean will be agreed in advanc ...
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Vaginal Delivery
A vaginal delivery is the birth of offspring in mammals (baby, babies in humans) through the vagina (also called the "birth canal"). It is the most common method of childbirth worldwide. It is considered the preferred method of delivery, with lower morbidity and mortality rate, mortality than Caesarean sections (C-sections). Epidemiology United States 70% of births in the United States in 2019 were vaginal deliveries. Global 80% of births globally in 2021 were vaginal deliveries, with rates varying from 95% in sub-Saharan Africa to 45% in the Caribbean. Benefits of vaginal delivery Mother Benefits for the mother include * Avoiding surgery and resulting quicker recovery time and shorter hospital admission * Quicker onset of lactation * Decreased complications in future pregnancies, including Placenta praevia, placenta previa Infant Benefits for the infant include: * Develop microbiota from exposure to the gut bacteria from the mother's gut, while the microbiota ...
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Obstetrics
Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field. Main areas Prenatal care Prenatal care is important in screening for various complications of pregnancy. This includes routine office visits with physical exams and routine lab tests along with telehealth care for women with low-risk pregnancies: Image:Ultrasound_image_of_a_fetus.jpg, 3D ultrasound of fetus (about 14 weeks gestational age) Image:Sucking his thumb and waving.jpg, Fetus at 17 weeks Image:3dultrasound 20 weeks.jpg, Fetus at 20 weeks First trimester Routine tests in the first trimester of pregnancy generally include: * Complete blood count * Blood type ** Rh-negative antenatal patients should receive RhoGAM at 28 weeks to prevent Rh disease. * Indirect Coombs test (AGT) to assess risk of hemolytic dis ...
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Breastfeeding
Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that breastfeeding begin within the first hour of a baby's life and continue as often and as much as the baby wants. Health organizations, including the WHO, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than vitamin D, are typically given. WHO recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond. Of the 135 million babies born every year, only 42% are breastfed within the first hour of life, only 38% of mothers practice exclusive breastfeeding during the first six months, and 58% of mothers continue breastfeeding up to the age of two years and beyond. Breastfeeding has a numb ...
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Surgical Suture
A surgical suture, also known as a stitch or stitches, is a medical device used to hold body tissues together and approximate wound edges after an injury or surgery. Application generally involves using a needle with an attached length of thread. There are numerous types of suture which differ by needle shape and size as well as thread material and characteristics. Selection of surgical suture should be determined by the characteristics and location of the wound or the specific body tissues being approximated. In selecting the needle, thread, and suturing technique to use for a specific patient, a medical care provider must consider the tensile strength of the specific suture thread needed to efficiently hold the tissues together depending on the mechanical and shear forces acting on the wound as well as the thickness of the tissue being approximated. One must also consider the elasticity of the thread and ability to adapt to different tissues, as well as the memory of the threa ...
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Pfannenstiel Incision
A Pfannenstiel incision , Kerr incision, Pfannenstiel-Kerr incision or pubic incision is a type of abdominal surgical incision that allows access to the abdomen. It is used for gynecologic and orthopedics surgeries, and it is the most common method for performing Caesarian sections today. This incision is also used in Stoppa approach for orthopedics surgeries to treat pelvic fractures. The Pfannenstiel incision offers a large view of the central pelvis but limits exposure to the lateral pelvis and upper abdomen, factors that limit the usefulness of this incision for gynecologic cancer surgery. This incision is commonly called the "bikini line incision". Some common reasons for this surgical access are obstetric delivery and hernia repair. It is often used in preference to other incision types for the sake of aesthetics, because the scar will be hidden by the pubic hair. The incision does not distort the belly button and heals faster than the traditional vertical incision. The ...
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Breech Birth
A breech birth is when a baby is born bottom first instead of head first, as is normal. Around 3–5% of pregnant women at term (37–40 weeks pregnant) have a breech baby. Due to their higher than average rate of possible complications for the baby, breech births are generally considered higher risk. Breech births also occur in many other mammals such as dogs and horses, see veterinary obstetrics. Most babies in the breech position are delivered via caesarean section because it is seen as safer than being born vaginally. Doctors and midwives in the developing world often lack many of the skills required to safely assist women giving birth to a breech baby vaginally. Also, delivering all breech babies by caesarean section in developing countries is difficult to implement as there are not always resources available to provide this service. OB-GYNs do not recommend home births if a breech birth is expected, even when attended by a medical professional. Cause With regard to the ...
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Pelvis
The pelvis (plural pelves or pelvises) is the lower part of the trunk, between the abdomen and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also called bony pelvis, or pelvic skeleton). The pelvic region of the trunk includes the bony pelvis, the pelvic cavity (the space enclosed by the bony pelvis), the pelvic floor, below the pelvic cavity, and the perineum, below the pelvic floor. The pelvic skeleton is formed in the area of the back, by the sacrum and the coccyx and anteriorly and to the left and right sides, by a pair of hip bones. The two hip bones connect the spine with the lower limbs. They are attached to the sacrum posteriorly, connected to each other anteriorly, and joined with the two femurs at the hip joints. The gap enclosed by the bony pelvis, called the pelvic cavity, is the section of the body underneath the abdomen and mainly consists of the reproductive organs (sex organs) and the rectum, while the pelvic f ...
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Obstructed Labor
Obstructed labour, also known as labour dystocia, is the baby not exiting the pelvis because it is physically block during childbirth although the uterus contracts normally. Complications for the baby include not getting enough oxygen which may result in death. It increases the risk of the mother getting an infection, having uterine rupture, or having post-partum bleeding. Long-term complications for the mother include obstetrical fistula. Obstructed labour is said to result in prolonged labour, when the active phase of labour is longer than 12 hours. The main causes of obstructed labour include a large or abnormally positioned baby, a small pelvis, and problems with the birth canal. Abnormal positioning includes shoulder dystocia where the anterior shoulder does not pass easily below the pubic bone. Risk factors for a small pelvis include malnutrition and a lack of exposure to sunlight causing vitamin D deficiency. It is also more common in adolescence as the pelvis may not ha ...
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Urinary Catheter
In urinary catheterization a latex, polyurethane, or silicone tube known as a urinary catheter is inserted into the bladder through the urethra to allow urine to drain from the bladder for collection. It may also be used to inject liquids used for treatment or diagnosis of bladder conditions. A clinician, often a nurse, usually performs the procedure, but self-catheterization is also possible. A catheter may be in place for long periods of time (indwelling catheter) or removed after each use (intermittent catheterization). Catheter types Catheters come in several basic designs: *A Foley catheter ( indwelling urinary catheter) is retained by means of a balloon at the tip that is inflated with sterile water. The balloons typically come in two different sizes: 5 cm3 and 30 cm3. They are commonly made in silicone rubber or natural rubber. *An intermittent catheter/Robinson catheter is a flexible catheter that is removed after each use. Unlike the Foley catheter, it has no ...
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