lower segment caesarean section definition?

Lower segment Caesarean section
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Lower segment Caesarean section
Pfannenstiel2.JPG
First description of Pfannenstiel's incision.
C-sec suture.jpg
A Pfannenstiel incision for a caesarian section closed with surgical staples. The superior aspect of mons pubis and pubic hair are seen at bottom of the image.
Comparison of incisions used for caesarean section
Is: Supra-umbilical incision
Im: Median incision
IM: Maylard incision
IP: Pfannenstiel incision

A lower (uterine) segment Caesarean section (LSCS) is the most commonly used type of Caesarean section.[1] Most commonly to deliver the baby a transverse incision is made in the lower uterine segment above the attachment of the urinary bladder to the uterus. This type of incision results in less blood loss and is easier to repair than other types of Caesarean sections.
Contents

1 Method
2 Etymology and history
3 References
4 Further reading

Method

A vertical incision in the lower uterine segment may be performed in the following circumstances:[2]

presence of lateral varicosities
constriction ring to cut through it
deeply engaged head

The location of an LSCS is beneficial for the following reasons:[citation needed]

peritoneum is more loosely attached to the uterus
contraction is less than in upper part of uterus
healing is more efficient
sutures are intact (less problem with suture loosening)

Most bleeding takes place from the angles of the incision, and forceps can be applied to control it. Green Armytage forceps are specifically designed for this purpose.[3]

Although the incision is made using a sharp scalpel, care must be taken not to injure the foetus, especially if the membranes are ruptured, or in emergencies like abruption. The incision can be extended to either sides using a scissor or by blunt dissection using hands. While using the scissors, the surgeon should ensure that a finger is placed underneath the uterus so that the foetus in protected from unintentional injury. If blunt dissection is done, intraoperative blood loss can be minimized. In cases where Pfannenstiel incision cannot be done (such as large baby), Kronig incision (low vertical incision),[4] classical (midline), J[5] or T shaped incisions[6] may be used to incise the uterus.[7]

Abdominal wall incision that exposes anterior wall of the uterus

Abdominal wall incision that exposes anterior wall of the uterus
Pull-out of the newborn baby

Pull-out of the newborn baby
Complete extraction of newborn out of the womb

Complete extraction of newborn out of the womb
Cleaning prior to handing the newborn to the pediatrics team

Cleaning prior to handing the newborn to the pediatrics team
Chance for mom to meet the baby

Chance for mom to meet the baby
Suturing of the uterus

Suturing of the uterus

Etymology and history

The German gynecologist Hermann Johannes Pfannenstiel (1862–1909) invented the technique.[8] In the United Kingdom, the surgery was first popularised by Dr. Monroe Kerr, who first used it in 1911, so in English speaking countries it is sometimes called the Kerr incision or the Pfannenstiel-Kerr incision. Kerr published the results in 1920, proposing that this method would cause less damage to the vascularized areas of uterus than the classical operation. He claimed that it was better than the longitudinal uterine incision in terms of chances for scar rupture and injury to vessels.[9]
References

Powell, John (2001). "The Kerr Incision". Journal of Pelvic Surgery. 7 (3): 77–78. Retrieved 17 December 2016.
Obstetrics Simplified - Diaa M. EI-Mowafi > Caesarean Section Geneva Foundation for Medical Education and Research. Edited by Aldo Campana, September 4, 2008
Lower segment Caesarean section Primary Surgery: Volume One: Non-trauma. Prev. Chapter 10. The surgery of labour
"Cesarean Delivery: Overview, Preparation, Technique". 2017-08-16.
Zou, Li; Zhong, Shaoping; Zhao, Yin; Zhu, Jianwen; Chen, Lijuan (April 2010). "Evaluation of "J"-shaped uterine incision during caesarean section in patients with placenta previa: a retrospective study". Journal of Huazhong University of Science and Technology Medical Sciences. 30 (2): 212–216. doi:10.1007/s11596-010-0216-z. ISSN 1672-0733. PMID 20407876. S2CID 195679609.
Boyle, J. G.; Gabbe, S. G. (February 1996). "T and J vertical extensions in low transverse cesarean births". Obstetrics and Gynecology. 87 (2): 238–243. doi:10.1016/0029-7844(95)00388-6. ISSN 0029-7844. PMID 8559531. S2CID 25233309.
Josef, Fischer (2006-12-18). Mastery of Surgery (4 ed.). Lippincott Williams & Wilkins. p. 1818. ISBN 9780781771658. Retrieved 17 December 2016.
Elsevier (2003). Dorland's Illustrated Medical Dictionary (30th ed.). Philadelphia: Elsevier. ISBN 978-0-7216-0146-5.

Powell, John (2001). "The Kerr Incision". Journal of Pelvic Surgery. 7 (3): 77–78. Retrieved 17 December 2016.

Further reading

Lower segment Caesarean section Primary Surgery: Volume One: Non-trauma. Prev. Chapter 10. The surgery of labour

vte

Tests and procedures relating to pregnancy and childbirth
Maternal tests

Pregnancy test Leopold's maneuvers Prenatal testing

Fetal tests
Imaging

Obstetric ultrasonography
Nuchal scan Anomaly scan Fetal movement counting Contraction stress test Nonstress test Vibroacoustic stimulation Biophysical profile
Amniotic fluid index Umbilical artery dopplers

Sampling

Chorionic villus sampling Amniocentesis Triple test Quad test Fetoscopy Fetal scalp blood testing Fetal scalp stimulation test Percutaneous umbilical cord blood sampling Apt test Kleihauer–Betke test Lung maturity
Lecithin–sphingomyelin ratio Lamellar body count Fetal fibronectin test

Other

Cardiotocography

Interventions

Fetal surgery Fetendo Podalic version
External cephalic version Amnioinfusion

Delivery
Vaginal delivery
Induction

Artificial rupture of membranes Episiotomy Symphysiotomy Forceps in childbirth Ventouse in childbirth Odon device

Dystocia management

McRoberts maneuver Wood's screw maneuver Zavanelli maneuver

Third stage of labor

Manual placenta removal

Caesarean section

Elective On maternal request EXIT procedure Resuscitative hysterotomy

Postpartum hemorrhage

Hysterectomy B-Lynch suture

Categories:

Obstetric surgeryCaesarean sections

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This page was last edited on 10 February 2022, at 18:17 (UTC).
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