C-Section

As a result of the improvement of anesthesia methods, the presence of strong antibiotics against sterility and infection problems, the development of surgical suture materials and the advancement of surgical techniques, cesarean surgeries have become an extremely safe and easy procedure.

The cesarean can be done at the request of the patient or it can be done against some medical necessities. These medical imperatives may be due to the mother or baby or to the specific conditions of pregnancy.

Again cesarean surgery to be performed can be at different pregnancy weeks according to the course of pregnancy. In general, the aim is to catch the best time for the mother and baby.

Optional (elective) cesarean section:

In our country, optional cesarean rates in hospitals are increasing day by day, especially in recent years.

Here, without any medical necessity, by the preferences of the parents, after the baby's day (after the 38th week), a cesarean is performed on a determined day.

The most common reason for voluntary cesarean deliveries is that the expectant mother is afraid of normal birth, does not want to take long-term action, does not want to put her baby at the slightest risk, and the desire to avoid the long-term negative effects of normal delivery (such as sagging of the uterus and bladder).

The baby does not progress to the uterine canal:

The baby's coming to the birth canal as a side, breech or cross may cause problems in normal birth.

Normally, in 95% of all pregnancies, the baby progresses first, other conditions are seen in 5%. In such cases, cesarean is performed by many physicians in order not to risk the baby.

Placenta (spouse) part to completely close the cervix: In this case, progression of the baby in the birth canal will create bleeding problems and risk both mother and baby life.

Early separation of the placenta (spouse):

The separation of the placenta from the uterine wall prior to the birth of the baby is called “ablation placenta” or “placental detachment”. In such a situation, the flow of oxygen and food sources to the baby is disturbed. Since the mother and baby life due to bleeding is at risk, the baby should be delivered urgently in this case.

Macrosomia (Big Baby):

In the case of ultrasound, the estimated weight of the baby is more than normal. Especially in the first pregnancies, if the baby's prediction weight is determined to be more than 4000 grams in the near future, cesarean can be planned directly by not risking normal birth.

Incompatibility between the baby's head and the bone structures of the expectant mother (Cephalopelvic incompatibility):

This situation is called as "narrow roof" among the public. The anatomical structure of the mother's hip bone and the suitability of the baby's head for this area affect the decision of the way of delivery. In cases where the hip bone roof is narrow or the baby's head diameter is wide despite the normal roof, the method to be chosen is cesarean.

Multiple pregnancies:

Although it is not a requirement, cesarean is preferred in such pregnancies. Vaginal delivery is avoided, especially if there are three or more babies.

In the case of twin pregnancies, if the leading baby is breech and the back is the head, this is an absolute cesarean requirement since the body of the first baby can be locked with the baby in the back.

Some abnormalities about the baby:

There may also be a cesarean requirement in the presence of some structural abnormalities that make it impossible for the baby to pass through the birth canal. The most important example of this situation is the cases of "gastroschisis" and "omphalocele" in which the abdominal wall of the baby is not closed and its internal organs are outside. When there is a vaginal birth, serious injuries occur in these organs.

In cases such as some skeletal system diseases and neural tube defect, cesarean is also required. In the presence of conjoined twins (siamese twins), cesarean is also applied.

Myomas in the womb:

They can make vaginal delivery impossible by narrowing the birth canal. Vaginal delivery is also avoided in the presence of giant condyloma (genital warts).

Situations in which is risky:

Similarly, caesarean section is preferred because it will cause discomfort in problems such as brain aneurysm.

Similarly, caesarean section is preferred because it will cause discomfort in problems such as brain aneurysm.

Herpes infection in the mother:

In the presence of an active genital herpes infection in the expectant mother, the baby can get the infection while passing through the birth canal. This is a very risky situation. In the presence of active genital herpes, vaginal delivery is never considered.

Some of the operations that the mother had before:

Cesarean may be required due to previous cesarean section, myomectomy (taking fibroids from the uterus), herniated disc or vaginal surgeries.

Vaginismus or birth fears:

Vaginismus is a condition characterized by involuntary contractions of the vagina during sexual intercourse. It is not possible to monitor birth by vaginal examination in these women, which are generally hysterical. In cases where the expectant mother is excessively afraid of normal birth or cannot tolerate the examination, cesarean can be performed without any medical necessity.

Complication During Delivery:

Urgent cesarean delivery may be necessary in the presence of findings suggesting that the baby is in distress during NST examinations during or before labor (tramway) monitoring. In the event of a baby's development retardation in the womb, strict pregnancy monitoring is required. further increase the baby's distress may require emergency cesarean section.

Having meconium in the amniotic fluid:

The intestinal content (feces) of the baby is called "meconium". The baby's meconium during labor (tram) shows that it is in trouble.

If the baby swallows meconium, a postpartum lung infection may develop. Therefore, although meconium is not necessary in the amniotic fluid, cesarean can be preferred.

If the labor does not progress:

Regular uterine contractions and the opening of the cervix occurs despite strong need for cesarean section or the baby's condition to stroke his head down.

The most important reason for the progression of the action is that the baby's head cannot enter the birth canal properly. From time to time, the baby's head can be worn in the middle of the birth canal as the action proceeds as it should be. In this case, cesarean is required.

Cord sagging or cord leading:

When the amniotic sac is opened, the umbilical cord of the baby can protrude out of the cervix, this is called “cord sagging”. In this extremely urgent situation, the cord can be pinched, causing blood to be cut and the baby to die.

Mother's vagina cord by inserting a field hand person pushes into the uterus and in the presence of cord prolapse surgery this condition go into the room. The person does not take his hand out of the vagina until the baby is fully born.

If the cord takes the lead in manual examination without opening the water bladder, this is called "cord leading". Again, the procedure to be performed is cesarean operation.

In some cases, the doctor may recommend the mother-to-mother especially cesarean. In cases such as advanced maternal age where pregnancy is very difficult to achieve or a second chance of pregnancy, pregnancy occurs after IVF, cesarean can be preferred to avoid the risks of normal birth to the baby and to guarantee that the baby is born alive.

This situation, formerly referred to as "precious baby" in our literature, was later abandoned due to the meaninglessness of this term. Whatever happens, all babies are precious, not a single precious baby.

Op. Sibel Malkoç, MD

Gynecology and Obstetrics Specialist

Dr. Sibel Malkoç attended many domestic and international training seminars and congresses during 25 years of specialised physician service.

Pregnancy follow-up, urinary incontinence surgery and laser treatments, genital aesthetic surgery and laser applications and vaginismus treatment are of special interest.

It serves its patients especially in surgical and laser-assisted Vagina aesthetics.

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