Types of C-section

What is a caesarean section?

A caesarean section, commonly known as a c-section, is a surgical delivery method where a baby is born after an incision in the mother's abdominal wall and uterus. This procedure is deemed necessary when complications prevent the baby from being delivered vaginally. 

A c-section surgery can be planned if there are indications that a vaginal birth is impossible, or it can be performed as an emergency if issues arise during labour. However, a vaginal delivery is typically considered the safest method for the baby if no severe medical problems arise during pregnancy or labour.

A caesarean section is a significant surgical procedure; although complications are infrequent, they can be severe. So, it is crucial to be well-informed before deciding on this procedure.

Reasons to undergo a caesarean section

There are many different reasons why a c-section may be a requirement, including:

• There are complications during pregnancy, such as pre-eclampsia or gestational diabetes, that could harm the mother or baby.
• Foetal distress means the baby is not getting enough oxygen or is in distress.
• Abnormal baby position, such as breech or transverse position, can make a vaginal delivery difficult or dangerous.
• Labour complications, such as failure to progress or cephalopelvic disproportion, which means the baby's head is too big to fit through the mother's pelvis,
• Previous c-sections may make a vaginal birth riskier.
• Maternal preference is when a woman has had a traumatic vaginal birth experience in the past or has a medical condition that makes a vaginal birth difficult or dangerous.
• Suppose the mother is expecting twins, triplets, or more. Twins are frequently born vaginally, but if there are triplets or more, the mother will almost likely require one.

Types of C section

There are two types of caesarean sections:

• Planned (elective) c-sections: These are scheduled in advance when the mother or baby has a medical condition that makes a vaginal delivery risky. Some doctors suggest a planned c-section for babies diagnosed with congenital issues to reduce delivery complications. Non-medical reasons may lead some women to prefer c-section surgery over vaginal birth.
  This choice has certain advantages and disadvantages for the mother and the child. It can also have an impact on future pregnancies.

• Unplanned C-sections: Most C-sections are unplanned since the need for one does not emerge until considerably closer to or during labour. Moms in these circumstances had planned on having a vaginal birth. Yet just before the baby is born, the mother and the doctor determine that a C-section is the best course of action.
  It might be upsetting and stressful when things change. Still, the medical team makes every effort to ensure that the birth experience is pleasant and safe for mother and child.
• Emergency c-sections: The urgency of the procedure distinguishes an emergency caesarean from an unplanned one. These are done when problems arise during labour, such as when the baby is distressed, the mother is not progressing as expected or is exhausted because of long labour. 
  Other issues requiring this procedure are when the mother's health conditions may not support a vaginal delivery, the umbilical cord is tangled around the foetus, or a womb ruptures. Emergency c-sections are done as quickly as possible to ensure the safety of the mother and baby.
  Both c-section involve incisions in the mother's abdomen and uterus to deliver the baby. The type and location of the incision can vary depending on the mother's medical history, the size and position of the baby, and other factors. The mother's experience and the actual process for an emergency C-section will differ from the processes of a planned or unplanned C-section.

Overview of the procedure

During a caesarean section, or c-section surgery, the baby is delivered through an incision in the mother's abdominal wall and uterus. The procedure typically takes 45 to 60 minutes but may take longer, depending on the circumstances. First, the mother is given anaesthesia to numb the lower half of her body. This may be in the form of a spinal block or epidural, administered locally through an injection. This allows the mother to remain awake and alert to experience the birth. 

Next, the surgeon makes a horizontal or vertical incision in the lower abdomen, usually below the pubic hairline. The abdominal muscles are then separated, and the uterus is exposed. The surgeon will make an incision in the uterus and gently remove the baby. The umbilical cord is clamped and cut, and the medical team assesses the baby.

After the baby is safely delivered, the placenta is removed from the uterus. The uterus is then closed with sutures or staples, and the incision in the abdomen is closed using stitches or surgical glue. The mother is monitored closely for any signs of complications, such as excessive bleeding or infection. Pain medication is also provided to manage any discomfort after the procedure.

Risks and complications of C-section

The risks and complications of a caesarean section are as follows:

• Infection in the wound as well as the uterus.
• Blood loss, which may need a blood transfusion.
• Damage to neighbouring organs like the bladder or bowel.
• Blood clots, which can be deadly if they reach the lungs.
• Adhesions are scar tissue bands that can grow in the belly and cause pain or intestinal blockage.
• Recovery time is longer, and pain and discomfort are greater than vaginal birth.
• Trouble breastfeeding owing to anaesthetic effects and the mother's extended recovery period.
• Increased chance of future pregnancy difficulties, such as placenta previa and uterine rupture.

This is not a comprehensive list, and the risks and complications may vary depending on the case.

Meril Life offers various surgical equipment, like sutures for procedures such as C-sections. Meril Life offers synthetic absorbable sutures such as MITSU AB^TM - Polyglactin 910 suture with Triclosan that minimises the risks of suture-induced surgical site infections (SSI) by inhibiting the colonization of pathogens.

In addition to sutures, Meril Life offers MERIFEIM, an absorbable gelatin sponge hemostat used for controlling/stopping the blood loss, made of a highly purified, biodegradable gelatin material. MERIFEIM can be easily absorbed by the body over time, eliminating the need for a separate removal procedure. The sponge has a porous structure and can absorb its weight in blood many times, which promotes platelet aggregation and clotting. 

MERIFEIM is an effective tool for achieving hemostasis in surgeries, reducing bleeding time, and minimising complications. This product can be used for abdominal, genito-urinary, otolaryngological, gynaecological, partial nephrectomy, and hepato-biliary surgeries. 

Conclusion

The risks and complications of a caesarean section are as follows:

There may be a need for a C-section for various reasons, including complications during pregnancy, foetal distress, abnormal positioning of the baby, labour complications, and previous C-sections. There are three types of C-sections: elective, unplanned, and emergency. Elective C-sections are scheduled in advance due to concerns about the safety of vaginal delivery. In contrast, emergency C-sections are performed when complications arise during labour. 

While "unplanned" and "emergency" C-sections are sometimes used interchangeably, they refer to two different types of situations where a C-section may occur. An unplanned C-section is when the decision to perform a C-section is made during labour. Still, there is no immediate threat to the mother or baby's health.

While C-sections are generally considered safe, they come with certain risks and potential complications, such as infection, blood loss, and organ injury. However, C-sections can also be lifesaving for both mother and baby in certain situations. The benefits of a C-section include a lower risk of pelvic floor injuries, which can lead to urinary or bowel incontinence, and a lower risk of birth trauma for the baby.