Mary is not progressing in labor appropriately, and the decision has been made to move toward a cesarean section. She understands, agrees, and signs the consent for surgery. You will again accept this patient in the recovery - or initial postpartum period.

Recognize that you will complete BUBBLEHE assessment. In addition, the abdominal assessment will also include assessment of the incision. Note the type of dressing used to cover the incision. Is it approximated? Is there any bleeding? Does she have bowel sounds? Is the abdomen distended? Is it soft? Do you assess the fundus and where is it located? It should be firm. Note pain assessment.

 

Susan P. had a SVD (spontaneous vaginal delivery) today approximately 2 hours ago. The labor and delivery nurse is calling to give you report. She is new and not sure what you want to know from her.

What questions do you need to ask to provide comprehensive care to this patient once she is transferred into your care?

In a few decades, caesarean section has gone from being an

almost exceptional intervention to the way one in four children come into the

world. Regardless of how worrisome this tendency to medicalize labor is, the

truth is that it doesn't hurt to know all the details: Caesarean section

preparations They usually last from 15 to 30 minutes. Before starting the

intervention, a dropper is placed on the woman to balance blood pressure, the

upper area of ??pubic hair is shaved, the skin of the abdomen is cleaned,

anesthesia is administered (if it has not been used until now) and, when has

taken effect, a tube is put into the bladder to keep it empty of urine. The

epidural allows the mother to see the birth of her child, and sometimes even

share it with her partner (not all doctors are in favor of the father entering

the operating room). The baby does not suffer the effects of anesthesia because

the drug acts directly on the nerves, and does not pass into the maternal

blood, and therefore not to the child. When injecting anesthesia, the doctor

usually asks the woman to put herself in a fetal position, that is, with her

knees at chest level, to favor the extension of the spine. cut Once the

anesthesia has taken effect, surgery begins. Usually, a transverse (horizontal)

cut of skin is made at the upper edge of the pubic hair (this is called the

'Pfannenstiel incision'). After cutting the skin, the fat is separated and the

fascia is cut transversely, which is a strong layer that supports the abdominal

muscles and intestines. The abdominal muscles are separated, not cut. The

peritoneum, a thin pouch where the abdominal organs accumulate, is gently torn

with the fingers. Thus the uterus is accessed. This is opened with a cross

section through an area called a segment, which is located between the neck and

the body of the uterus, to remove the baby.

The uterus is sewn with a thread that is reabsorbed in 40 days. The peritoneum develops again on its own, so it is best not to sew it. The layer that supports the abdominal muscles is then sutured back with a similar thread.

The skin wound can be closed with staples or a nylon thread under the skin, leaving the scar thinner and more homogeneous. Both are removed in a few days.

From the beginning of cutting the belly to the final suture, about 40-60 minutes elapse if there are no incidents. In most caesarean sections, the mother and the newborn could go together from the operating room to the room and start breastfeeding in the first hour of the baby's life, just like vaginal delivery.

The effect of anesthesia wears off in an hour or two. Painkillers (pain relievers) are then put into the serum periodically. Most of these drugs are perfectly compatible with breastfeeding.

The serum dropper can be removed 8 to 12 hours later, just like the bladder tube, thus preventing urinary tract infections. The mother can drink liquids from four hours after the intervention.

Susan P. had an SVD (spontaneous vaginal delivery) today about 2 hours ago. The labor and delivery nurse is calling to inform you. She is new and she is not sure what you want to know about her.

What questions should you ask to provide comprehensive care to this patient once she is transferred to your care?

• Rest as much as possible. The only thing you can do is eat, sleep, and care for your baby. And that is fine. You will have blood loss, as if you had an out-of-date menstrual period, for almost six weeks.

• You may also have swollen legs and feet, feel constipated, and have cramps. Even if you are not breastfeeding, milk may come out of your nipples and your breasts may feel sore, tender, or uncomfortable.

• Follow your doctor's directions for physical activity you can do in the coming weeks, such as climbing stairs and walking.

• Doctors typically recommend not having sex four to six weeks after delivery.

In addition to the physical changes, you may feel sad. If you are very sad or unable to care for yourself or your baby, you may be suffering from a serious condition called postpartum depression.

https://www.serpadres.es/embarazo/parto-posparto/articulo/cesarea-paso-a-paso

https://americanpregnancy.org/es/labor-and-birth/cesarean-procedure/

https://medlineplus.gov/spanish/postpartumcare.html