Sectio Caesarea

5/28/2018 Sectio Caesarea

1/13

Sectio Caesarea

Preceptor :

dr.Eddi Junaidi,SpOG,SH,M.Kes

By :

David Rizki Akhirul Zamril


2/13

Prologue

Cesarean delivery is defined as the birth of afetus through incisions in the abdominal wall

(laparotomy) and the uterine wall (hysterotomy).

According (Mochtar, 1998) Cesarean delivery is

defined as the birth of a fetus with incisions in thethe uterine wall (hysterotomy) through abdominal

or vagina wall.

This method had to be done to prevents maternal

and fetal death caused by complication that can

be acquired if the labor of the fetus through

normal delivery


3/13

Epidimiology

In indonesia birth rate with sectio caesarea in12 teaching hospital ratio is between 2,1%-

11,8%. In sanglah denpasar hospital sectio

caesarea within 10 years (1984-1994) 8,06%-

20,23%


4/13

Indication Sectio Caesarea in advance

Country

IndicationSectio Cesarea every 100 birth

Norwegia Skotlandia Swedia USADistosia 3,6 4,0 1,8 7,1Has been sc before 1,4 3,1 3,1 8,5Breech position 2,1 2,0 1,8 2,6Fetal distress 2,0 2,4 1,6 2,2others 3,7 2,7 2,4 3,2Sectio Caesarea 12,8 14,2 10,7 23,6


5/13

Indication of Sectio Caesarea

passage, passenger , power , mother pshycology Problems???normal labor and birth risked for fetal and maternal death

Mother indication : Age

Pelvic volume

History sectio caesarea delivery before Obstacle of birth passage

Abnormal contration of the uterus

Premature membran rupture

Afraid of the pain

Fetal indication : fetal distress Makrosemia

Breech position

Plasenta Factor : plasenta previa, solution plasenta, plasenta accreta

Abnormalty of the umbilical cord : umbilical cord prolaps, umbilical cord

strangle


6/13

Contraindication of Sectio Caesarea

principaly sectio cesarea delivery is done formother and fetal safety so in obstetric way

there is no contraindication for sectio

caesarea delivery for an emergency situation


7/13

Classification

Transperitoneal profunda Sectio cesarea surgery done by doing incision ln the lower segment of

the uterus

Classical Sectio cesarea(corporal) The incision is in the upper segment of the uterus or in

the corpus uteri Vaginal Sectio cesarea

Surgery on the anterior vaginal wall through to uteruscavity

Ekstraperitoneal Sectio cesarea Sectio operation without peritoneum incision done by

pushing the peritoneum layer into the cranial andvesica urinaria into caudal or midline and then openthe uterus by doing incision in the lower segment


8/13

Sectio Caesarea Technic


9/13

Classical Sectio Caesarea (corporal)

Benefit : Faster fetal delivery

Doesnt cause complication such as retraction of

the vesica urinaria

The incision can be prolonged to proksimal or

distal area

Lost :

The infection can easily speard through intraabdominal because there is no good

reperitonealisation process

Increased rate for spontaneous uteri rupture on

the next labor


10/13

Transperitoneal Profunda Sectio

Caesarea

Benefit : Wound suturing much easier

Wound closure with reperitonealisation

Peritoneal overlapping is pretty good to hold the

spreading of the uterus composition to peritoneum

cavity

Less bleeding

There is lower chance of the spontaneus uteri

rupture Compare with the classical way

Lost :

Higher rate of vesica urinaria negative symptom


11/13

Complaction of the Sectio Caesarea

Severe sepsis

Tromboemboli attack

Damage in tractus urinarius Infection on the wound

Bleeding


12/13

Post Operation Sectio Caesarea Care

Wound care of the incision area Post operation instalation care

Fluid and nutrition balance

Pain management Mobilisation


13/13

Documents

Sectio Caesarea