Cesarean section

Dr Daniel J Bell et al.

Cesarean section (also known as C-section, CS and C/S) is the most frequently done major abdominal surgery in females 1

Surgical technique

Many forms of Cesarean section have been described, but the most popular variation is the low transverse approach following a Pfannenstiel or Joel-Cohen skin entry. Following sharp skin opening, blunt dissection down to the fascia is performed. After which, a transverse incision of the fascial layer is done, with a subsequent blunt division of the rectus abdominis muscles and then careful access into the peritoneal cavity. This is to reduce the risk of accidental iatrogenic trauma to the proximate organs e.g. bowel, bladder, etc. This dissection is considerably more difficult if pre-existing adhesions are present.

Before entry into the uterus, the surgeon assesses the fetal lie, then makes a short low transverse cut through the myometrium. Occasionally a vertical incision is performed instead, a so-called “classical cesarean incision". The baby is delivered using extrinsic uterine pressure, with the attached placenta following.

After delivery, the myometrium is repaired using a single or double suture layer. Next the fascial and skin layers are closed. Peritoneum may or may not be closed, but the abdominal wall muscles are usually left divided 1.

Complications

Acute
Chronic
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Article information

rID: 73007
Synonyms or Alternate Spellings:
  • Caesarean section (CS)
  • Emergency Caesarean section
  • Emergent Caesarean section
  • Emergency Caesarean
  • Emergent Caesarean
  • Cesarean section

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