Sectio Caesarea is a way of delivery of a fetus by making an incision on the front wall of the uterus
through the abdominal wall
To save the mother and baby through the abdominal wall incision to remove the baby and prevent the occurrence of abnormal bleeding in the mother and baby to facilitate issuing improper presentation
Sectio Caesarea Classic (corporal)
Performed by making an incision in the uterine corpus extends approximately along 10 cm.
Pros: 1. Removing fetal faster 2. Not lead to bladder complications 3. Incision can be extended proximally or distally
Disadvantages: 1. Intra-abdominal infection is easily spread because there is no good riperitonearisasi 2. Subsequent to delivery more frequent spontaneous uterine rupture
cross section Surgical incision made at the bottom of the uterus (SBR). Transverse incision starting from the tip or edge of the crotch (simphysisis) above the pubic hairline along about 10-14 cm.
profit Scarring of the uterus sufficiently strong that a small risk of suffering from uterine rupture (tearing of the uterus) in the future. This is because at the time of parturition, the lower uterine segment is not much to contract so that the wound can heal more perfect operation
Sectio Caesarea ismika (deep)
Performed by making an incision transversely-concave on the lower segment of the uterus (low transverse cervical) is approximately 10 cm. Pros: 1. Suturing the wound more easily 2. Closing wounds with good reperitonealisasi 3. Overlap of peritoneal flat splendidly to contain the spread of uterine contents into the cavity periutoneum 4. Bleeding less 5. Compared to the classical way of spontaneous uterine rupture probability less or smaller. Disadvantages: 1. Wounds can be widened to the left, right, and bottom, so it can cause uterine bleeding broke up and intense. 2. Complaints on high postoperative bladder.
Prosedur umum bedah caesar - bagian pengiriman deep- transperitoneal : A. insisi garis tengah vertikal kulit antara umbilikus dan symphisis pubis , diikuti dengan lapisan demi lapisan pemisahan lemak subkutan , otot , fasia dan peritoneum dari dinding perut . B. Setelah uterus gravid terkena , lembar peritoneal antara dinding anterior rahim dan dinding bagian atas / posterior dari kandung kemih diidentifikasi dan dipotong, kemudian dipisahkan . Semakin rendah wilayah garis tengah dinding rahim anterior kemudian dipotong dengan sayatan tajam kecil . C. Melalui sayatan kecil , dinding rahim dibagi lebih lanjut lateral menggunakan jari operator . Membran amnion kemudian dipotong untuk mendapatkan akses ke rongga rahim . D. Pengiriman dari bayi dan plasenta . E & F. Penutup perbaikan dinding rahim , menggunakan ganda / dua lapis jahitan dianjurkan . Pendarahan di rongga rahim harus dikontrol terlebih dahulu sebelum perbaikan ini . G. Penutup perbaikan peritoneum , diikuti dengan lapisan demi lapisan penutupan dinding perut .
General procedures of a deep-transperitoneal cesarean-section delivery : A. vertical midline incision of the skin between the umbilicus and the pubic symphisis, followed with layer-by-layer separation of the subcutaneous fat, muscle, fascia and peritoneum of the abdominal wall. B. After the gravid uterus is exposed, the peritoneal sheet between the anterior wall of the uterus and the upper / posterior wall of the urinary bladder is identified and cut, and then separated. The lower midline region of the anterior uterine wall is then cut with a small sharp incision. C. Through the small incision, the uterine wall is divided further laterally using the operators fingers. The amniotic membrane is then cut to gain access to the uterine cavity. D. Delivery of the baby and the placenta. E & F. Closing repair of the uterine wall, using double / two-layer sutures recommended. The bleeding in the uterine cavity must be controlled first before these repairs. G. Closing repair of the peritoneum, followed with layer-by-layer closure of the abdominal wall.