High-Risk Obstetrics Painless Labour Normal Delivery Lower Segment Caesarian Section. (LSCS)Painless Labour.Normal Delivery.Lower Segment Caesarian Section (LSCS)High-Risk Obstetrics is where due to certain physical & mental conditions the health of the mother & child is a potential risk.
A high-risk pregnancy can be a function of a mother’s pre-existing medical condition or result from developments during the pregnancy. Underlying conditions, such as diabetes, high blood pressure, epilepsy or anaemia, can also increase pregnancy risks. For mothers aged above 40, high-risk pregnancies are more common
Complications that develop during the pregnancy such as problems with the uterus, cervix or placenta, or fetal environment, can all increase pregnancy risks.
Prior C-sections, a history of pregnancy loss, low birth weight baby or preterm birth (birth before 37 weeks of pregnancy), and antibody development are some factors that may increase the risks for subsequent pregnancies.
While pregnancy can be put at risk through the use of tobacco, alcohol, administration of illegal drugs, and poor diet.
The high-risk obstetrics patients are under special care throughout and sometimes under special medications relevant to the type of the health issues.
The technique of painless delivery called Epidural Analgesia or Epidural Anaesthesia is a popular technique used by women, if advised by the doctor, during labour. It gives relief from unbearable labour pain during deliveries. Epidural anaesthesia allows mothers to have a painless delivery the natural way. It is the most popular method of pain relief during labour.
An epidural is a way to deliver an anaesthetic so that it stops pain signals travelling from the spine to the brain. It involves injecting a small amount of anaesthetic into the epidural space of the spine. The epidural space is filled with fluid and surrounds the spinal cord. Nerves that carry pain signals from the body to the brain connect to the spinal cord in certain places. The anaesthetic numbs the spinal nerves, blocking the pain signals.
A spontaneous vaginal delivery (SVD) occurs when a pregnant female goes into labour without the use of drugs or techniques to induce labour, and delivers her baby in the normal manner, without forceps, vacuum extraction, or a cesarean section.
A lower segment Caesarean section (LSCS) is the most commonly used type of Caesarean section. It includes a transverse cut 1-2 centimetres above the attachment of the urinary bladder to the uterus, called the Pfannenstiel incision in the lower segment. This type of incision results in less blood loss and is easier to repair than other types of Caesarean sections.
Presence of lateral varicosities.Constriction ring to cut through it. Deeply engaged head.Peritoneum is more loosely attached to the uterus.Contraction is less than in the upper part of the uterus. Healing is more efficient.Most bleeding takes place from the angles of the incision. Forceps can be applied to control it. Green Armytage forceps are specifically designed for this purpose.
Although the incision is made using a sharp scalpel, care must be taken not to injure the foetus, especially if the membranes are ruptured, or in emergencies like abruption. The incision can be extended to either side using a scissor or by blunt dissection using hands. While using the scissors, the surgeon should ensure that a finger is placed underneath the uterus so that the foetus is protected from unintentional injury. If blunt dissection is done, intraoperative blood loss can be minimized. In cases where Pfannenstiel incision cannot be done (such as a large baby), Kronig incision (low vertical incision),] classical (midline), J or T shaped incisions may be used to incise the uterus
Provide information on pregnancy and birth and discuss with the couple about the place, time and mode of the delivery provisionally and care of the newborn.Ensure continued medical surveillance and prophylaxisAdvice the mother about breastfeeding, postnatal care and immunization.Advice and support to the woman and her family for developing healthy home behaviours.