medical notes

Apr 17th, 2015
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CESAREAN DELIVERYIntroductionCesarean delivery is defined as the birth of a viable fetus(es) (?500gm), placenta and membranes through incisions in the abdominal wall (laparotomy) and the uterine wall (hysterotomy). This definition does not include removal of the fetus from the abdominal cavity in the case of rupture of the uterus or in the case of an abdominal pregnancy.FrequencyKNH - 20% (1991)On the increase due to;There is reduced parity, and almost half of pregnant women are nulliparas. Therefore, an increased number of cesarean births might be expected for conditions that are more common in nulliparous women e.g. dystocia, PETOlder women are having children - the frequency of cesarean deliveries increases with advancing age.Electronic fetal monitoring - concern for an abnormal fetal heart rate tracing prompts operative delivery with the listed indication being some form of labor arrest.Breech presentationsPrior cesareanConcern for malpractice litigation - Failure to perform a cesarean and thus avoid adverse neonatal neurological outcome or cerebral palsy and seizures is the dominant claim in obstetrical malpractice litigationSocioeconomic and demographic factors - Maternal requestIndicationsMaternalPrevious cesarean - A repeat cesarean is indicated if;- Previous cesarean was a classical cesarean (suffers uterine rupture prior to labor or if given a trial of labor)- The previous uterine incision extended into the upper contractile portion of the myomet

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