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CESAREAN DELIVERY AND CESAREAN HYSTERECTOMY

Jul 19, 2008

Cesarean Delivery_

  • it is a removal of infant from uterus through an incision of the abdominal wall and the uterus
Indication of Cesarean Delivery:
  • fetal distress
  • prolapsed of the umbilical cord
  • pre mature rupture of the placenta
  • complete placenta previa
  • active herpes infection
  • malprsentation and malposition of the fetus
  • tumors obstructing the birth canal
  • cephalopelvic disproportion
  • uterine dysfunction and cervix can not dilate
Types of Cesarean Delivery:
  1. Low segment- incision made transversely in lower segment of the uterus. Usually this type of incision is as request of the patient
  2. classical cesarean section -incision directly into the wall of the uterus for transverse lie position

Cesarean Hysterectomy- it is a cesarean section followed by the removal of uterus

INDICATIONS:
  • ruptured uterus
  • intrauterine infection
  • severe dysplasia or carcinoma
  • multiple fibro myomas
  • defective uterine scar
  • laceration of uterine vessels
PREOPERATIVE CARE FOR HYSTERECTOMY:
  • Inform the patient, husband or direct member of the family and get the consent for operation
  • remove jewelries, dentures and nail polish if there is any
  • monitor vital signs of the patient and the fetal heart beat
  • prepare for blood examinations and the results
  • shave the patient from mid- breast line down to mid-thigh
  • keep the patient nothing orally at least eight hours
  • carry out pre operative medications as prescribed
POST OPERATIVE CARE FOR HYSTERECTOMY
  • placed patient flat on bed and head turned on one side
  • monitor vital signs, every 30 minutes for first hour
  • check Intravenous fluid and regulate correctly
  • check urinary catheter if flowing freely
  • check dressing if there is a sign of hemorrhage
  • if awake encourage deep breathing frequently
  • after 8 hours may put pillow and lie on the side slowly and slightly and supported with pillow
  • on the first day may sit on the bed
  • sponge bath for hygiene and promote blood circulation
  • on the second day , may stand at bed side with the presence and help of the nurse especially on the first time
  • on the third day , may walk slowly around her bed with someone on her side for help in case of feeling dizziness or pain
  • if catheter removed , encourage to void
  • may take bath on the third day with assistant

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