Cesarean Delivery , Emergency : Risks/Benefits

Obstetrică - ginecologie

Risks/Benefits:
1.Risks:
-infection;
-injury to maternal tissues and internal organs;
-injury to fetus at delivery;
-need for application of vacuum or forceps to expedite delivery in cesarean section;
-10% of patients undergoing emergent CD require transfusion due to severe maternal hemorrhage;
-risks of transfusion reactions and acquired infections from blood products;
-risk of hysterectomy for intractable uterine hemorrhage;
-risk from administration of aneathesia;

2.Benefits:
-decrease in short- and long-term morbidity;
-in cases of severe maternal hemorrhage , maternal morbidity and mortality are decreased.

Complications:
1-Infection:
-wound infection;
-wound dehiscence;
-wound seroma;
-wound hematoma;
-uterine infection,endometritis;
-pneumonia;
-UTI;
-pyelonephritis;
-mastitis;
2.-Thromboembolic events:
-DVT/PE (deep venous thrombosis/pulmonary embolism);
-septic pelvic thrombophlebitis;
3.-Hemorrhage/Bleeding:
-Fatigue;
-Orthostatic hypotension with syncope;
-Iron deficiency;
-Need for transfusion;
-Need for hysterectomy;
-Maternal mortality;
4.-Injury to internal organs:
-bladder injury requiring prolonged catheterization;
-ureteral injury;
-bowel injury with or without colostomy;
-bowel resection due to extensive injury;
-excision of fallopian tube and/or ovary for the control of severe hemorrhage;
5.-Risk of anesthesia:
-aspiration of gastric contents;
-high spinal with need for endotracheal intubation;
-inability to ventilate with maternal hypoxia and brain injury;
-maternal mortality due to hypoxia or cardiovascular collapse.

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