Caesarean section is the delivery of the baby alive or dead through an abdominal uterine incision after the period of viability.

• Various indications to do a cesarean include maternal factors like Pelvic contraction, Fibroid in lower segment of uterus or cervix, Pelvic tumours, Major degree placenta praevia, Previous abortions, severe Preeclampsia(high blood pressure),Failure to progress, history of Infertility or Maternal request.
• Fetal factors like Malpresentation eg breech position, big baby and Fetal distress (low fetal heart rate)

Preop preparation:

• Basic Investigations done include CBC , PTI, INR, APTT
• Anaemia is treated
• Stomach should be empty.
• Informed written consent.
• Antibiotic prophylaxis: Given prior to incision.
• Urinary catheter is put.

Anaesthesia

Regional anaesthesia preferred: Spinal. General anaesthesia in some cases.

Procedure

• Skin incision may be transverse(most of the cases) or vertical. Layers of abdomen are cut including subcutaneous tissue and fat, rectus sheath, muscles and peritoneum.
• Uterine incision is transverse. After taking the baby out the layers are closed. Skin in closed with absorbable or non absorbable sutures.

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Post operative care

• Occlusive dressing applied for 48 hrs.
• Dressing changed after 48 hrs, wound inspected. Non occlusive dressing done.
• Suture removed after 7 -8 days.
• Monitoring of vitals and bleeding.
• Pain relief is given.
• NSAIDs, Patient controlled analgesia.
• Ambulation after 24 hrs. Urinary catheter is removed
• Prophylactic antibiotics are given