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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Cesarean Section for a Previous Uterine Operation
What is a cesarean section?
A cesarean section is an operation that delivers a baby
through a cut in your abdomen and uterus. The uterus is the
muscular organ at the top of the vagina. Babies develop in
the uterus, and menstrual blood comes from the uterus.
When is it used?
If you have had a previous operation on your uterus, such as
a cesarean section or myomectomy, your uterus has a scar.
Because scar tissue is weaker than muscle, the scar from
your previous operation might open during labor. If it
opens, it endangers you and your baby. It is very rare for
a scar to open if it is from a previous cesarean section in
which the cut was made across the uterus. In such cases you
can usually try to deliver the baby vaginally (using the
birth canal).
However, if you had a cesarean section with a vertical cut
in your uterus, or a myomectomy that went through your
uterine wall, the risks are higher. In these cases a
cesarean section may be scheduled.
You should ask your doctor about these choices.
How do I prepare for a cesarean section?
Plan for your care and recovery after the operation,
especially if you are to have general anesthesia. Allow for
time to rest and try to find other people to help you with
your day-to-day duties.
Follow instructions provided by your doctor. If you are to
have general anesthesia, eat a light meal, such as soup or
salad, the night before the procedure. Do not eat or drink
anything after midnight and the morning before the
procedure. Do not even drink coffee, tea, or water.
If you go into labor, call the doctor.
What happens during the procedure?
You are given a regional or general anesthetic. A regional
anesthetic numbs part of your body, preventing you from
feeling pain while you remain awake. A general anesthetic
relaxes your muscles, puts you to sleep, and also prevents
you from feeling pain.
The doctor makes a cut below your belly button and into the
lower part of the uterus to remove the baby. The doctor
removes the baby, placenta, and birth sac. The doctor then
sews the uterus and abdomen closed.
What happens after the procedure?
You may stay in the hospital about 2 to 4 days, depending on
your condition.
Avoid heavy lifting for 6 weeks. After 6 weeks begin an
exercise program to regain your abdominal muscle tone. Ask
your doctor what other steps you should take and when you
should come back for a checkup.
What are the benefits of this procedure?
Delivering a baby by cesarean section may be safer for you
and the baby. You can avoid some of the pain of labor.
You may be able to schedule the time of the delivery.
What are the risks associated with this procedure?
- There are some risks when you have general anesthesia.
Discuss these risks with your doctor.
- A regional anesthetic may not numb the area quite enough
and you may feel some minor discomfort. Also, in rare
cases, you may have an allergic reaction to the drug used
in this type of anesthesia. In most cases regional
anesthesia is considered safer than general anesthesia.
- A blood vessel may rupture or be cut and bleed inside the
body.
- A piece of blood clot may break off, enter the
bloodstream, and damage the lungs.
- The cut in the wall of the uterus may leave a weak part
in the wall.
- Any future children may need to be delivered by cesarean
section, based on how this cesarean section was done.
- You may develop an infection or bleeding.
You should ask your doctor how these risks apply to you.
When should I call the doctor?
Call the doctor immediately if:
- You develop a fever.
- You become dizzy or faint.
- You experience nausea and vomiting.
- You become short of breath.
Call the doctor during office hours if:
- You have questions about the procedure or its result.
- You want to make another appointment.
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