Maternal and Child Nursing
, Caesarean Delivery Nursing Care Plan and
Management
Description
1. In this surgical procedure, the new born is delivered through the
abdomen from an incision made through the maternal abdomen and
the uterine myometrium.
2. The surgery may be preplanner (elective) or arise from an
unanticipated problem.
3. Two incisions are made: one in the abdominal wall (skin incision)
and the other in the uterine wall. Either of two skin incisions is used:
a midline vertical incision between the umbilicus and the symphysis
or a Pfannenstiel incision just above the symphysis (Fig. 1). Three
types of uterine incisions are possible (Fig. 2): (1) low transverse; (2)
low vertical; and (3) classic, a vertical incision into the upper uterus.
The low transverse uterine incision is preferred unless a very large
foetus or placenta previa in the lower uterus prevents its use. The
uterine incision does not always match the skin incision. For
example, a woman may have a vertical skin incision and a low
transverse uterine incision, particularly if she is very obese.
4. In subsequent pregnancies and delivery, a trial of labour and vaginal
birth is increasingly regarded as safe and appropriate as long as
cephalopelvic disproportion does not exist and the previous incision
was low transverse.
5. Elective, repeat caesarean may be performed in the absence of a
specific indication for operative delivery when either the physician or
the client is unwilling to attempt vaginal delivery.
6. Anaesthesia may be general, spinal, or epidural; preoperative and
postoperative care will vary accordingly.
, Caesarean Delivery Nursing Care Plan and
Management
Description
1. In this surgical procedure, the new born is delivered through the
abdomen from an incision made through the maternal abdomen and
the uterine myometrium.
2. The surgery may be preplanner (elective) or arise from an
unanticipated problem.
3. Two incisions are made: one in the abdominal wall (skin incision)
and the other in the uterine wall. Either of two skin incisions is used:
a midline vertical incision between the umbilicus and the symphysis
or a Pfannenstiel incision just above the symphysis (Fig. 1). Three
types of uterine incisions are possible (Fig. 2): (1) low transverse; (2)
low vertical; and (3) classic, a vertical incision into the upper uterus.
The low transverse uterine incision is preferred unless a very large
foetus or placenta previa in the lower uterus prevents its use. The
uterine incision does not always match the skin incision. For
example, a woman may have a vertical skin incision and a low
transverse uterine incision, particularly if she is very obese.
4. In subsequent pregnancies and delivery, a trial of labour and vaginal
birth is increasingly regarded as safe and appropriate as long as
cephalopelvic disproportion does not exist and the previous incision
was low transverse.
5. Elective, repeat caesarean may be performed in the absence of a
specific indication for operative delivery when either the physician or
the client is unwilling to attempt vaginal delivery.
6. Anaesthesia may be general, spinal, or epidural; preoperative and
postoperative care will vary accordingly.
