Cesarean: indications, consequences, and planning for future pregnancies

What is a cesarean section?

A cesarean section is a surgical procedure during which an obstetrician delivers the baby through an incision made in the abdominal wall and the uterus of the woman in labor. This method is used in cases where natural childbirth may pose a risk to the mother or the child. The operation is performed under general, regional, combined anesthesia, or local infiltration. After a cesarean section, the woman typically stays in the maternity ward for 2 to 3 days longer than after a vaginal delivery.

Indications for Cesarean Section

The operation can be planned (performed after 39 weeks of pregnancy) or done in an emergency.

Planned Cesarean Section

It is scheduled in advance when the doctor anticipates complications during natural childbirth. Indications include:

• fetal presentation by the breech;
• malposition of one of the fetuses in case of multiple pregnancies;
• transverse presentation;
• monozygotic twins;
• growth retardation syndrome of one of the fetuses in case of multiple pregnancies;
• HIV infection;
• primary genital herpes 6 weeks before delivery;
• extragenital pathology;
• trauma or pelvic tumors that prevent natural delivery;
• cervical cancer;
• conditions following third-degree lacerations of the cervix or plastic surgical interventions in the perineal area;
• gastroschisis, diaphragmatic hernia, spina bifida, fetal teratoma, conjoined twins.

Emergency Cesarean Section

Indications for an emergency intervention:

• Hemorrhage before the onset of labor or during the first stage of labor;
• threat of uterine rupture or uterine rupture that has occurred;
• severe pre-eclampsia or eclampsia;
• failure to induce labor;
• fetal distress;
• prolapse of pulsating umbilical cord loops;
• labor anomalies;
• state of agony or clinical death of a pregnant woman with a living fetus.

Preoperative Preparation

Before the operation, a number of examinations are performed: determination of hemoglobin levels, hematocrit, platelets, as well as blood type and Rh factor. Antibiotic prophylaxis is prescribed to the patient. The anesthetist assesses the general condition of the woman and determines the anesthetic risk.

Consequences of Cesarean Section

The woman is mandatory informed of the possible consequences:

• If a new pregnancy occurs within two years following the cesarean section, there is an increased risk of placenta previa or placental abruption, as well as uterine rupture during a trial of natural delivery;
• Such a pregnancy is not an indication for pregnancy termination;
• Contraceptive recommendations are the same as for women who have delivered vaginally.

It is important to strictly adhere to personal hygiene rules during the postoperative period. Regular check-ups with a gynecologist-obstetrician are mandatory. In cases of severe extragenital pathology, prevention of potential complications is carried out in coordination with a specialist.

Planning the Next Pregnancy

During the first year following the cesarean section, it is recommended to use reliable contraceptive methods. The timing of the next pregnancy should be discussed with the treating gynecologist-obstetrician. The doctor will assess your health condition and indicate when it is safe to conceive a child for both the mother and the child.

Specialist Advice

The gynecologists-obstetricians at Natuvitro clinic support natural pregnancies and those resulting from in vitro fertilization (IVF). To receive specialized advice, including issues related to the necessity of a cesarean section, schedule an appointment for informed consultation.