Gynecological surgery process

Caesarean section is a relatively common delivery procedure at present. Because of the consideration of umbilical cord entanglement, malposition of the fetus or various factors leading to difficult labor, in order to ensure the health of the baby and the pregnant woman, the hospital will recommend caesarean section to pregnant women. Before the caesarean section, mothers should maintain a happy mood, not be overly nervous and anxious, and must relax their minds, because only in this way can the operation be guaranteed to proceed smoothly.

Detailed process of cesarean section

Preoperative preparation

Before the operation, the expectant mother should maintain a happy and calm mood and avoid excessive tension and anxiety. When waiting for delivery, she can relax by listening to music, reading leisure books and communicating with other pregnant women. She can also relive every beautiful moment of pregnancy with the expectant father.

The following are some preoperative preparations that require the cooperation of expectant mothers:

1. Pay attention to get more rest. Make sure you get enough sleep the night before the operation and eat easily digestible food. Do not drink water or eat anything for at least four hours before the operation.

2. Clean the abdomen and vulva thoroughly. If you have a deep navel, clean it in advance.

3. Before the operation, the nurse will prepare you as follows:

a. Blood matching: Take 2-3 ml of venous blood for blood matching when blood transfusion is needed during surgery;

b. Skin preparation: Use a razor to shave the hair on the abdomen, waist, etc.;

c. Intramuscular injection of anti-bleeding injections, etc.;

d. Placement of urinary catheter;

e. Initial disinfection of abdominal skin.

4. If you do not go to the operating room immediately after the surgery is ready, please lie on your side and wait.

5. Remove hairpins, removable dentures, contact lenses, jewelry, etc. and hand them over to family members for safekeeping.

6. After giving birth, pregnant women will be transferred to the postpartum ward or room. Family members need to pack their personal belongings in advance in preparation for bed transfer and keep valuables with them.

7. When a pregnant woman is sent to the operating room, family members must accompany her and wait in the waiting area outside the operating room.

Procedure

(1) Incision of the abdominal wall: After the surgical site is determined, the surgeon will clean, shave, disinfect, and anesthetize the area as usual. First, an arc-shaped incision will be made. Then, the skin and muscles, external oblique muscles, internal oblique muscles, transverse abdominal muscles, and their fascia will be incised in layers. Any blood vessels should be avoided or double ligated. Then cut the peritoneum. When cutting the peritoneum, use tweezers to pick it up and make a small cut. Then the operator inserts the middle finger or index finger of the left hand into the incision, and under the guidance of the left hand, cut the peritoneum to an appropriate length to expose the stomach and intestines.

(2) Pulling out the uterus: After the peritoneum is incised, the surgeon's arm should be disinfected again and rinsed with saline, then inserted into the abdominal cavity to examine the uterus, fetus and nearby organs to check for rupture and adhesion. Then have an assistant move the stomach and intestines forward to expose the uterus. The pessary is pushed out of the incision. When pulling the uterus, move slowly and at an angle. Excessive force can easily tear the uterus. After the uterus is pulled out, a large piece of multi-layer sterile gauze should be placed between the uterus and the edge of the incision to prevent the fluid in the uterus from flowing into the abdominal cavity and causing infection.

(3) Uterine incision: After identifying the greater curvature of the uterine horn, avoid the uterine caruncle and cut through the uterine wall with one cut. After fully ligating the bleeding point of the uterine wall incision, carefully separate the fetal membrane near the incision. If the membrane is full of amniotic fluid, make a small cut to release the amniotic fluid first. Choose the appropriate location and direction for releasing the tire water. After part of the amniotic fluid has been released, use scissors to extend the amniotic membrane incision and flip the cutting edges on both sides toward the sides of the uterine incision and fix them. In this way, the cutting edges of the everted amniotic membrane form a biological wound, and the amniotic fluid will not leak into the abdominal cavity when it flows out, causing contamination.

(4) Pulling out the fetus: When removing the fetus, grasp the tarsal part of the fetus' hind limb or the wrist of the forelimb along the uterine incision and slowly pull the fetus out in the most suitable direction and angle. If the incision is too small, it can be enlarged. After pulling out the fetus, the assistant should secure the uterus to prevent it from retracting into the abdominal cavity. The pulled out fetus should be cared for as a normal delivery baby.