What to know about Cesarean sections
Hemorrhage
This is defined as blood loss of 1000ml or more, accompanied by signs and symptoms of hypovolemia (critical loss of blood volume) within 24 hours after birth.
This can look like soaking through one pad in an hour.
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Symptoms of hypovolemia
Increased bleeding
Decreased blood pressure
Increased heart rate
Surgical site infection
Surgical site infections often manifest as endometritis (inflammation of the lining of the uterus), wound infection and uterine tract infections. They have been divided into three, namely superficial incisional, deep incisional and organ/scape infection.
Superficial incisional infections have been described as infections that only involve the skin and subcutaneous tissue (tissue directly under the skin).
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Deep incisional infections are described as infections that the soft tissue, fascia( thin connective tissue that surrounds each organ) and muscle.
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Organ/Space infections are described as infections that go deeper and involves the organs such as the uterus.
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Signs and symptoms of infections
Purulent discharge (the infection discharges pus)
Fever greater than 38 degrees Celsius
Pain that does not go away with pain killers.
Tenderness in the wound area
Swelling
Redness
Heat
Coloured discharge
Venous thromboembolism
This is a disorder that includes deep vein thrombosis (DVT) and pulmonary embolism (PE). A DVT occurs when a blood clot forms in a deep vein, typically in the lower leg or thigh. A pulmonary embolism (PE) occurs when this clot breaks off and travels to the lungs. The risk of developing this is highest after a major surgery such as a C-section. The clots can cause a restriction in blood flow and if left untreated, this can lead to death.
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SYMPTOMS OF DVT
Swelling
Pain or tenderness
Redness and increased warmth in the affected limb
Symptoms of PE
Shortness of breath
Pain when deep breathing
Increased heart rate
Fast breathing
Difficulty breastfeeding
Research has shown that women who undergo C-sections are more likely to have difficulty breastfeeding, delay breastfeeding and stop breastfeeding early. The research shows that babies born via C-section are less likely to have skin-to-skin contact and this has been suggested as having an effect on the initiation, duration and maintenance of breastfeeding.
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Planned C-sections have been associated with reduced breastfeeding success when compared to vaginal birth. This may be as a result of problems with latching, positioning and more pain due to the C-section. Mothers who have had emergency C-sections have been found to have more difficulty with the first breastfeeding attempt, breastfeeding after 24 hours and after discharge.
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With this knowledge in mind, caring for women who have had C-sections and are experiencing difficulty with breastfeeding is important. The stress of a C-section coupled with societal pressures that the mother has failed for having a C-section can affect the mental health of the mother and would require support.
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