• High Risk Obstetrics Painless Labour Normal Delivery Lower Segment Caesarian Section (LSCS)

  • Painless Labour

  • Normal Delivery

  • Lower Segment Caesarian Section (LSCS)

High Risk Obstetrics

  • High Risk Obstetrics is where due to certain physical & mental conditions the health of the mother & child is at potential risk.

  • A high risk pregnancy can be a function of a mother’s pre-existing medical condition or result from developments during the pregnancy. Underlying conditions, such as diabetes, high blood pressure, epilepsy or anemia, can also increase pregnancy risks. For mother aged above 40 the high risk pregnancies are more common

  • Complications which develop during the pregnancy such as problems with the uterus, cervix or placenta, or fetal environment, can all increase pregnancy risks.

  • Prior C-sections, a history of pregnancy loss, low birth weight baby or preterm birth (a birth before 37 weeks of pregnancy), and antibody development are some factors that may increase the risks for subsequent all pregnancies.

  • While a pregnancy can be put at risk through use of tobacco, alcohol, administration of illegal drugs, and poor diet .

  • The high risk obstetrics patients are under special care throughout and sometime some under special medications relevant to the type of the health issues.

Painless Labour

  • The technique of painless delivery called as Epidural Analgesia or Epidural Anaesthesia is a popular technique used by women, if advised by the doctor, during labor. It gives relief from unbearable labor pain during deliveries. Epidural anesthesia allows mothers to have a painless delivery the natural way. It is the most popular method of pain relief during labor.

  • An epidural is a way to deliver an anesthetic so that it stops pain signals traveling from the spine to the brain. It involves injecting a small amount of anesthetic into the epidural space of the spine. The epidural space is filled with fluid and surrounds the spinal cord. Nerves that carry pain signals from the body to the brain connect to the spinal cord in certain places. The anesthetic numbs the spinal nerves, blocking the pain signals.

Normal Delivery

  • A spontaneous vaginal delivery (SVD) occurs when a pregnant female goes into labor without the use of drugs or techniques to induce labor, and delivers her baby in the normal manner, without forceps, vacuum extraction, or a cesarean section.

Lower Segment Caesarian Section (LSCS)

  • A lower segment Caesarean section (LSCS) is the most commonly used type of Caesarean section. It includes a transverse cut 1-2 centimetres above the attachment of the urinary bladder to the uterus, called the Pfannenstiel incision in the lower segment. This type of incision results in less blood loss and is easier to repair than other types of Caesarean sections.

It may be transverse (the usual) or vertical in the following conditions

  • Presence of lateral varicosities

  • Constriction ring to cut through it

  • Deeply engaged head

The location of an LSCS is beneficial for the following reasons

  • 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.

  • 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, intra operative blood loss can be minimized. In cases where Pfannenstiel incision cannot be done (such as large baby), Kronig incision (low vertical incision),] classical (midline), J or T shaped incisions may be used to incise the uterus