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ABSTRACT
Many aspects of cesarean section (CS) have changed over a period
of time. Indications of cesarean section currently include Intra
Uterine Growth Retardation and oligohydramnios as current
additions. Technological additions like Cardio Tocography (CTG)
have enabled obstetricians to pick up fetal distress early and
invite additional indications for C.S.
It is now recommended that pre-load should always be given to a
subject to be taken for CS. Currently epidural anesthesia and
spinal anesthesia are preformed over GA. Pre-load with lactated
ringer solution prevents a fall of BP in regional anesthesia.
Vertical midline incisions are now hardly used. Transverse
incisions are most preferred. For the delivery of the head when
deeply impacted, Patwardhan’s method is found to be safe and
successfully prevents extensions.
The habit of suturing the uterus in two layers has been found to
be useless. Now a day, uteri on CS are sutured in a single
layer. Synthetic absorbable materials (like Vicryl) are
preferred due to many advantages. Suturing of peritoneum
both visceral and parietal are found to be unnecessary
especially when the abdomen is opened by a transverse incision.
Infact leaving the peritoneum unsutured prevents subsequent
adhesions including that of the bladder to the uterus. Skin
stitches are now preferred as subcuticular or by stapling.
Antibiotics preferred now are in prophylactic doses rather than
in the age-old curative regimes. A dose of appropriate
antibiotic given during surgery and the other dose after 6 hrs
is all that is required for these cases.
Many such current trends have made cesarean sections a lively
proposition and no more the same old drab surgery.
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