p Bicornuate uterus: this usually
would lead to abnorma
presentation or lie of baby and also
poor progress of labor
p One of the rarest causes for a CS is
when resuscitation is being
performed or in the unfortunate
case when the mother dies and a
Caesar is done to save the baby’s
life.
Risks of Caeserean Sections
Some people believe that a Caeserean
Section is a panacea. Don’t get me
wrong I strongly believe with a good
indication a CS should be performed
promptly when indicated, but
everyone should understand that it is
not without risks.
Some of our colleagues may argue that
a vaginal delivery also has risks and I
concur but the role of an obstetrician
is to weigh the risks of an individual
client or patient and come up with
a decision that would have a better
prognosis fo r both the baby and
mother.
It is not always black and white and
it is not as easy as it sounds and is
usually the cause of a lot of litigation
making the profession less attractive
in certain countries but that can be a
discussion for another day.
So what risks are associated with
Caeserean Sections? Several risks
are associated with having a CS that
include:
p Heavy bleeding: Generally it is
accepted that blood loss during a
CS is higher than that during a
normal delivery. There are various
techniques to minimize the
amount of blood lost but in some
instances especially previous scars
with bad scar tissue or dhesions,
when the uterus does not
contract after delivery, patients
with bleeding disorders and so on
bleeding can be severe enough
and can in unfortunate cases even
abdominal or pelvic surgeries.
lead to death. This is especially so in
peripheral facilities where access to p Endometriosis (cells from the
blood and drugs can be a challenge.
uterine lining that grow outside the
womb) causing pain.
p Infection: Wound infection is quite p Negative psychological
common after any form of surgery
consequences with unplanned
and a CS is no exception and due
caesarean.
to other factors such as anaemia
infections can also be severe
p Death
enough to lead to sepsis which is
very difficult to cure once it sets in. Our baby is not spared also and risks
to the baby include:
p Internal organs such as the urinary
bladder and intestines are at risk of p Accidental surgical cuts to
getting accidental cuts during
presenting part, sometimes severe
surgery and this is more so in
enough to require suturing.
patients who have had previous
surgery.
p Being born pre-term (34-36 weeks
of pregnancy) as a result of
p Patients undergoing a CS are more
scheduled surgery.
like to have their uteruses removed
because of uncontrollable bleeding p Complications of prematurity that
however even someone having a
include difficulties with breathing,
normal delivery can undergo the
digestion, liver function, jaundice,
same.
dehydration, infection feeding and
regulating blood sugar levels and
p Complications from anaesthesia
body temperature and some presuch as postdural puncture spinal
term babies may experience
headaches, drug allergies, difficult
learning or behavior problems in
intubation and so on.
school due to immature brains at
birth.
p Development of deep venous
clots that can travel to the lungs
p Readmission to hospital.
(pulmonary embolism) and brain
(stroke).
p Problems with breastfeeding
leading to childhood development
p Complications leading to
of asthma, sensitivity to allergens
admission to an intensive care unit.
or type 1 diabetes.
p Readmission to hospital for
p Death in the first 28 days of life.
complications related to the
surgery e.g. wound sepsis, incisional It is my trust that the pros and cons
hernias.
of Caeserean Sections are well rested
with you after navigating through
p Long standing pain: more women
this piece. We shall continue on the
report problems with pain from the journey to enlighten you more on this
caesarean incision than report pain and related matters via this column.
in the genital area after vaginal
birth.
Dr. Maureen Owiti is a Gynaecologist
based in Nairobi. You can commune with
p Adhesions, thick internal scar
her on this or related matters via mail at:
tissue that may cause future chronic [email protected].
pain and in rare cases a twisted
bowel and can complicate future