“Doctor, I want Caesar…”
I thought I was lucky last week when the senior asked me to go to the operation theatre (OT) as Caesarean section was scheduled for that day. This is my chance to observe the operation as close as possible. There were 2 patients in the ward who were posted for C-section. After checking their condition, the senior decided that the mothers should be transferred to the OT upstairs immediately.
To decide which patient is going for operation, it is not an easy task to do. It requires lots of experience to manage such patient, especially the care of pregnant woman at term because we deal with 2 precious lives here.
The most common reason for C-section is breech presentation of the baby. That means, the lower limb of the baby is engaged in the lower uterine segment. In this situation, the normal vaginal delivery should be avoided and should not be attempted.
In our hospital, any pregnant woman who is going for operation (C-section) should be given :
- Injection Rantac (ranitidine) – a H2 receptor blocker to increase the pH of the stomach.
- Injection Reglan (metoclopramide) – this is an anti-vomiting medication. It acts by increasing the tone of lower oesophageal sphincter
- Injection Taxim/Cefazoline – an antibiotic, to prevent infection.
The IV cannula is also set up so that colloids can be given to the patient intravenously. This maintains the hydration status as well as the minerals of the patient throughout the operation.
Foley’s catheter is inserted also to help the voiding of the urine. Delivery of the baby would be much easier. This may also avoid injury to the urinary bladder during the operation.
Some of the patient asks for c-section whenever they cannot bear the pain of the normal delivery. They thought that operation is the only choice to alleviate the intense pain. The truth is, a strict care should be given to the woman post-operatively, compared to those who deliver the baby normally, without any surgical intervention.
For those who have past history of c-section in the previous delivery, they should not be advised to have normal vaginal delivery. OR, there will be a risk of uterine rupture and consequently the patient end up with the uterus being removed (hysterectomy).
I personally think that, those who work in the maternity ward must have good control of emotion to manage any emergency situation. Why? As the delivery time is so unpredictable, it can happen anytime and anywhere also.
That’s why when the baby is delivered, I think the one conducting the delivery is so fortunate to bring one life to this world. I am so jealous with them and hope one day, I can be just like them…