Usted está por regresar a casa después de una cesárea. Es de esperar que necesite ayuda para cuidarse y para cuidar de su recién nacido. Hable con su pareja, padres, suegros o amigos.
Usted puede tener sangrado vaginal hasta por 6 semanas. Este lentamente se volverá menos rojo, luego rosado y posteriormente va a tener un color más amarillo o blanco. El sangrado y el flujo después del parto se llaman loquios.
Al principio, el corte (la incisión) estará ligeramente elevado y más rosado que el resto de la piel. Es probable que aparezca algo hinchado.
Usted necesitará una cita de control con su proveedor de atención médica en 4 a 6 semanas.
Si vuelve a casa con un apósito (vendaje), cambie el apósito que cubre su incisión una vez al día o antes si se ensucia o se moja.
Si se utilizaron cintas quirúrgicas (Steri-Strips) para cerrar la incisión:
Está BIEN bañarse y secarse la incisión dando toquecitos suaves con una toalla limpia.Levantarse y caminar una vez que esté en casa le ayudará a sanar más rápido y puede ayudar a prevenir la formación de coágulos sanguíneos.
Usted debe ser capaz de realizar la mayor parte de sus actividades regulares en 4 a 8 semanas. Antes de eso:
No haga abdominales. No conduzca un automóvil durante al menos 2 semanas. Está BIEN viajar en un vehículo, pero asegúrese de tener puesto el cinturón de seguridad. No conduzca si está tomando narcóticos para el dolor o si se siente débil o insegura al volante.
Trate de consumir comidas más pequeñas de lo normal y tome refrigerios saludables entre ellas. Coma muchas frutas y verduras, y beba 8 vasos (2 litros) de agua al día para evitar el estreñimiento.
Las hemorroides que desarrolle deben disminuir lentamente de tamaño. Algunas pueden desaparecer. Los métodos que pueden ayudar a los síntomas incluyen:
Puede comenzar a tener relaciones sexuales en cualquier momento después de 6 semanas. Igualmente, no olvide hablar con el proveedor acerca de los anticonceptivos después del embarazo. Esta decisión se debe tomar antes de dejar el hospital.
Después de una cesárea que siga a un parto difícil, algunas madres se sienten aliviadas. Pero otras se sienten tristes, decepcionadas o incluso culpables por necesitar una cesárea.
Llame a su proveedor si presenta sangrado vaginal que:
Llame también al proveedor si presenta:
8°C) que persiste (las mamas inflamadas pueden causar una ligera elevación de la temperatura)La preeclampsia posparto, si bien es poco frecuente, puede ocurrir después del parto, incluso si no padeció preeclampsia durante el embarazo. Llame a su proveedor de inmediato si usted:
Cesárea – regreso a casa
American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy.
Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-1131. PMID: 24150027 pubmed.ncbi.nlm.nih.gov/24150027/.
Beghella V, Mackeen AD, Jaunaiux ERM. Cesarean delivery. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 24.
Isley MM Postpartum care and long-term health considerations. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe’s Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 24.
Versión en inglés revisada por: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Traducción y localización realizada por: DrTango, Inc.
Hojee la enciclopedia
Dicho apósito se vigilará para constatar que no existe sangrado.
No realices movimientos bruscos que comprometan a la musculatura abdominal o afecten a la cicatrización. Viste prendas de algodón que permitan la transpiración, pues otros materiales pueden propiciar un caldo de cultivo para diversos microorganismos que podrían infectar la herida. 
Lucía Moya
Matrona
Modern technique caesarean section is that the incision of the skin and subcutaneous tissue is made along the lower fold of the abdomen in the transverse direction (according to Pfannenstiel) up to 15 cm long, or a transverse incision is made (according to Joel-Kohan ) 2-3 cm below the middle of the distance between the womb and the navel, 10-12 cm long.
This is a convenient and fairly quick operative access for caesarean section. Such an incision has its advantages: it has a good cosmetic effect, which explains the widespread use of this type of intervention, because both of these incisions create favorable conditions for intradermal suture. It is noteworthy that during a repeated caesarean section, an incision on the skin is made at the site of the previous scar with excision of the latter. Such an incision of the anterior abdominal wall allows for a more active postoperative period compared to a longitudinal (lower median) incision. The puerperal woman is allowed to get out of bed during the first day after the operation, which is the prevention of subinvolution of the uterus, intestinal paresis, the formation of adhesions and reduces the risk of thrombosis in the postoperative period.
Over the past 10 years, the technique of caesarean section has progressively changed. A prerequisite for this was the work proving that the unsutured visceral and parietal peritoneum does not entail any additional postoperative complications and even significantly reduces the likelihood of adhesions in the abdominal cavity.
Another prerequisite was the widespread use in surgical practice of synthetic (vicryl, polyglycolide) absorbable suture material, and therefore, when suturing an incision on the uterus, a single-row continuous suture is more often used. In patients with a single-row suture on the uterus (according to ultrasound data), edema in the area of the postoperative suture is observed 4 times less often than with a double-row suture. The suture on the uterus and aponeurosis is treated using argon plasma coagulation (APC). A feature of the APC is that the active electrode is blown with argon, ionized, and a torch is formed between the electrode and the tissue. In an environment of inert argon gas at a temperature of 120°C, tissue coagulation occurs to a depth of no more than 3 mm. In this case, there is no effect of carbonization-charring, since there is no direct combustion of the tissue, and there is also a direct thermal effect on the microbial agent. Due to APC, the healing processes are activated – as a result of deep tissue heating: myometrium in the suture area (to a depth of 10-15 mm) and reduction of collagen fibers due to tissue heat treatment.
The use of APC for caesarean section can reduce blood loss during surgery, improve the quality of life in the postoperative period by reducing pain and reducing the length of stay in the hospital. Direct antibacterial action makes it possible to refuse preventive course antibiotic therapy, promotes the healing of the surgical wound, and reduces the risk of purulent-inflammatory diseases in the postoperative period. In addition, the consistency of the scar on the uterus is achieved, which allows you to increase the percentage of subsequent spontaneous births.
The combination of several well-known techniques and the elimination of a number of optional steps make it possible to speak of Stark caesarean section as a new modification that has a number of advantages over conventional methods. These include rapid retrieval; a significant reduction in the duration of the operation; reduction of blood loss; reducing the need for postoperative use of painkillers; reduction in the incidence of intestinal paresis and other postoperative complications; earlier discharge for 3-4 days after birth.
The duration of a traditional surgical intervention is on average 40 minutes, and in the Stark modification – 22 minutes. Due to these advantages, as well as the simplicity of the method itself, this operation is quickly gaining popularity. Babies removed after a cesarean section according to Stark have a more stable adaptation, which allows them to be breastfed during the first minutes of life.
Our Maternity Hospital uses a new technique of “slow” caesarean section. A unique, gentle way of delivery “slow” caesarean section at 29maternity hospital! The method of “natural” or “slow” caesarean section, for patients with a contraindication for natural childbirth, was developed by English specialists in elite clinics in London. Its essence is as follows: the woman in labor is conscious, as in a conventional cesarean, the doctor makes a small incision and removes the baby’s head. Unlike a standard cesarean section, when the baby is quickly taken out, not giving the opportunity to adapt to environmental conditions, with a “slow” cesarean section, the child is given the opportunity to get out of the uterus on his own.
The mother is actively involved in the delivery process, she can watch how the baby is born. This method of operative delivery is safe for mother and baby, and it is gaining more and more supporters among women abroad, especially in the UK. Maternity Hospital at City Clinical Hospital No. 29is the only state maternity hospital in Moscow where this unique technique is used.
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Neonatological department
90,000 NENONATOLOGE SPbGPMU spoke about the characteristics of the kids-Caesarit, Associate Professor of Nononetrology of Larisa Fedorov. Peter’s portal about how a caesarean section can affect the health of a newborn Many are convinced that the operation itself has little effect on the further development of the child. However, according to doctors, the Caesareans still have some peculiarities.
– Cesarean section is an abdominal operation, and like any surgical intervention, it has a risk of complications, especially for the mother. In addition, the scars on the uterus remaining after the operation do not always give a woman a chance to give birth herself next time. And for a newborn, birth through the natural birth canal is the best option. With a caesarean section, the child does not receive the “birth stress” that will give him optimal adaptation to extrauterine life, and, therefore, to further development , – says the neonatologist of St.
Petersburg State Medical University Larisa Fedorova .
It is clear that a planned caesarean section is carried out for a reason – there are strict indications for this operation. This suggests that conventional childbirth can be complicated by a serious pathology for the mother or child. In addition, the operation is scheduled for a certain day, which does not always coincide with the “plans of the child” – he may not be ready to be born at that moment. There is also an emergency caesarean – when doctors decide on an operation already during childbirth, if something starts to go wrong or there is a risk of complications. In general, the situations are different, and the risks too, so it is difficult to compare all Caesars.
However, according to Larisa Fedorova, they still have some common features that distinguish them from children born naturally.
The first breath
In natural childbirth, the child receives the so-called “birth stress” – it is also hard and painful for him to be born.
In response to stress, a catecholamine surge occurs – the release of catecholamine hormones. They just start the baby’s adaptation mode to the outside world – they help to take the first breath, scream, provide a good tone, reflexes necessary for breathing and sucking. With a cesarean section, the child does not receive such severe stress. Here obstetricians come to the rescue, who immediately conduct tactile stimulation so that he, too, immediately breathes. Of course, in both cases, children take their first breath in the first seconds after birth, but this is achieved in slightly different ways.
Breathing problems
When passing through the birth canal, the baby seems to squeeze out excess fluid from the lungs. In cesareans, lung fluid is absorbed much more slowly. Therefore, almost one in four immediately after birth develops the so-called transient tachypnea of the newborn, which is manifested by shortness of breath and “grunting” breathing. It is also called wet lung syndrome or intrauterine lung fluid retention syndrome.
Usually it passes in 1-2 days and requires only the supervision of doctors. However, some children may still need special respiratory support. If help is provided on time, tachypnea will not affect the further development of the child.
Head shape
When a child is born through natural means, the so-called physiological birth configuration of the head occurs. Nature arranged it so that the bones of the skull of the fetus are specially movable to help it pass through the birth canal correctly. Therefore, during the first days and even weeks, the newborn may have overlapping bones and asymmetry of the skull. Then everything returns to normal – the bones straighten out. In general, the first year of life is the period of the most rapid growth of the skull. Due to the rapid development of the brain, the head circumference increases by 10-12 cm. A cesarean section is usually performed when the child has not yet entered the birth canal. Therefore, these children usually have a nearly round head.
Violation of the microbiome
The microbiota of the intestines, skin, mucous membranes are laid in utero. The baby, passing through the birth canal, comes into contact with the mother’s vaginal flora and with it receives beneficial bacteria. For example, a lot of lactobacilli. This is a kind of prevention of infections associated with environmental microorganisms. At the same time, beneficial bacteria colonize the baby’s intestines, forming the correct microflora in the future – this process takes place during the first 2-3 years of life. A lot depends on the state of the microflora. First of all, local and general immunity, food tolerance. In cesarean children who have not received beneficial bacteria from the intestinal and vaginal flora of the mother, food tolerance is reduced. Such children are more prone to allergies, in the first 4 months they are more likely to suffer from diarrhea.
Difficulties with breastfeeding
Breast milk contains many beneficial bacteria that complement the baby’s intestinal microbiota and give him protection from the first minutes of life.
That is why they try to attach a newborn to the mother’s breast immediately after birth so that he can receive precious drops of colostrum. The first contact of the baby with the mother is also important psychologically. After the operation, it is not always possible to do this – due to anesthesia in a woman (there are no contraindications for epidural anesthesia) or in general her condition. In such cases, the method of irrigation with colostrum of the oral cavity of the newborn is used. Sometimes after the operation, for some time, the mother may have contraindications for breastfeeding – for example, taking certain antibiotics. All this can delay lactation – enough milk will come later than usual.
Decreased immunity
We live in a non-sterile environment, and as long as the immune system is in order, the body maintains the right balance of good and bad bacteria and can resist infections. In cesarean babies, who did not receive beneficial bacteria from their mother during childbirth, this balance is initially disturbed.
In them, the colonization of the gastrointestinal tract occurs mainly by environmental microorganisms. If lactobacilli predominate in meconium in those born naturally, then in caesareans – staphylococci and enterococci. Also, potentially dangerous Klebsiella, Proteobacteria, Clostridia (alpha-toxigenic Clostridium perfringens) are more often isolated from them. These pathogenic and opportunistic bacteria at a “convenient” moment can easily become dangerous and start the disease.
Depression
If the mother had an operation under general anesthesia, the child may experience the so-called drug-induced depression. The baby may be lethargic for some time, weak. But, as a rule, a caesarean section now takes place with epidural anesthesia – during childbirth, the mother is conscious. Such an anesthetic benefit, as a rule, does not affect the child’s condition.
The risk of neurological diseases
How the food will be digested correctly, how the necessary nutrients will be fully absorbed, will depend on the development of the child.