Caesarean section for the second time. Planned caesarean section: timing of its implementation

Giving birth to a child is a function inherent in a woman by nature itself. However, sometimes you have to intervene in this process in the most persistent way, saving the health (and sometimes life!) of the mother and baby. One of these measures is a caesarean section, which, although used as an extreme necessity, is still not some kind of tragedy and does not put an end to reproductive system women.

Is a second caesarean section necessary for my next pregnancy?

Any surgical intervention in such complex system, How human body, leaves a certain trace. Caesarean is not only not an exception, but rather even an eloquent example. And it’s not even a matter of a scar on the upper tissues and skin, but, mainly, a broken integrity of the uterus. Repeated pregnancy, in which the walls of the uterus naturally stretch, can lead to suture rupture and tragic consequences. Therefore, if you are planning a second birth after a cesarean section, then it is very advisable to schedule it at least two (or even three) years after this operation. During this period of time, the uterus should recover and strengthen its walls. If a very short period of time has passed after the operation, a second caesarean section is predetermined.

If you follow the basic rules, contrary to popular belief, a woman has a good chance of giving birth to a child naturally. That is, the inability to give birth independently during the previous pregnancy does not mean that the mother will certainly have to have a second cesarean section. Decision on in an up-to-date way The doctor makes a birth based on an analysis of many factors, and more and more specialists prefer, if possible, natural childbirth.

Indications for a second cesarean section

There really aren't that many serious reasons for doctors to prescribe a cesarean section for the second time, but none of them tolerates being treated lightly. The most common indications:

Diseases and conditions that pose a threat: diabetes mellitus, asthma, vision problems, hypertension ( high blood pressure), recent traumatic brain injury, cardiovascular and central nervous system, oncology;
Excessively narrow or deformed pelvis;
The outcome of the first cesarean section is, first of all, the condition of the suture and its location;
Features of the fetus itself - unfavorable position, large size, as well as multiple births;
Postmaturity, weak labor activity;
Abortions suffered after cesarean section;
A short break between pregnancies;
Mother's age after 30-35 years.

The right of final decision remains with the woman, but it should not be abused. Doctors are in no way interested in a threat to the patient’s life, and therefore try to resort to the safest option for the woman in labor.

Features of re-operation

C-section the second time is unlikely to promise any surprises for the pregnant woman, but there are still some differences. Repeated surgery usually takes longer because the incision is not made along a complete line. skin, and in a rougher area - along the old seam. Plus, a second cesarean section requires more caution due to increased risks. Therefore, the anesthesia will also be stronger.

Another feature of the second cesarean section is the period at which it is performed. Often, a difficult pregnancy is sought to be completed as early as possible to eliminate the risks that threaten the mother or her baby. The longer and stronger the walls of the uterus are stretched, the higher the likelihood of rupture. However, if there are no obvious reasons for concern, then the operation is performed as planned, at 37-39 weeks or even later. Usually, a pregnant woman is offered to go to the maternity hospital a little early - for safekeeping.

Consequences of a second caesarean section

Recovery of the body will take a little longer than after the first cesarean section, the same applies to the suture. Repeated surgery can significantly harm a woman’s reproductive system. Violations are often observed menstrual cycle and even the impossibility of conceiving in the future, i.e. infertility. But some women manage to maintain their reproductive function, which, unfortunately, also poses a danger.

Pregnancy after a second cesarean section is associated with a number of serious risks to the health and life of the woman and the fetus. Therefore, doctors not only do not recommend that patients with such a history plan to have children again, but also suggest sterilization after a second cesarean section. Such concerns and the precautions associated with them, although justified, are still not mandatory. There are examples when mothers quite safely gave birth to both the third and fourth “Caesarean”. But in fairness, it is worth noting that not all women can boast of such truly good health. Risk is, of course, a noble cause, but preserving oneself for already born children is perhaps a higher mission.

Most often, if the first birth was carried out by cesarean section, then the second birth is carried out in the same way. Therefore, all women who have undergone a cesarean section during their first birth are advised, just in case, to be prepared for a second operation during childbirth. And here the question arises: how long does it take to do it? plan section during the second birth?

Before trying, which is also planned to be carried out surgically, doctors must make preparations for a caesarean section and draw up a specific plan for the entire range of measures. This plan implies a kind of strategy aimed at carrying out the safest birth possible.

A woman should know in advance at what time she will have a section during her second birth (except in cases emergency surgery caesarean section). The date of surgery will depend on many factors.

During the training process, doctors should:

Make attentive detailed analysis the condition of the scar on the wall of the uterus at the site of the first incision. If a second pregnancy occurs less than 3 years after the birth through first Caesarean child, then the second birth will most likely require surgery.
Check with the woman whether there have been abortions or any other types surgical intervention into the body between the first birth and the second pregnancy. If, for example, there was scraping of the endometrium, then this can have a very negative impact on the condition of the uterine scar.
It is necessary to clarify the number of fetuses during multiple pregnancies, as well as determine the features of their location in the womb and the type of presentation. During multiple pregnancy, the uterine wall is greatly stretched. This also has a very bad effect on the condition of the scar.

Indications for caesarean section during the second pregnancy

If during the examination it turns out that the placenta is attached to the uterus exactly where the scar is located, then there is no way to do without surgery.

Taking into account all these factors, doctors determine the timing of a repeat cesarean section. Most often, a woman is operated on one to two weeks earlier than the first time. This is usually 38 weeks of pregnancy. It is by this time that the process of synthesis of pulmonary surfactant begins in the baby’s body - a mixture of surfactants that lines the pulmonary alveoli from the inside, promoting the expansion of the baby’s lungs with the first breath.

Possible consequences

Possible complications for the mother

After a second cesarean section, a woman may have:

menstrual irregularities;
various types of inflammation and other complications in the scar area;
damage to tissues and internal organs – gastrointestinal tract, bladder, ureters;
loss of ability to become pregnant again;
thrombophlebitis (pelvic veins), anemia, endometritis;
severe bleeding in the uterus, which may require removal of the entire uterus;
high risk of complications in subsequent pregnancies.

For a newborn

The child may have a disorder cerebral circulation, there may be hypoxia due to prolonged exposure to anesthesia.

Recovery time

Recovery female body after the second one it takes longer and is more difficult than after the first operation. The tissue is cut in the same place twice, so the wound takes a very long time to heal. The stitch hurts and oozes for 7-15 days. The uterus contracts longer, causing severe discomfort. It will be possible to start putting your figure in order no earlier than in 2 months, depending on general health women in labor.

A repeat cesarean section is recommended for women who cannot or do not want to give birth to a second child on their own, since the very fact of having the first operation does not exclude the possibility of giving birth independently in a second pregnancy. If a second surgical birth is coming, it is important for a woman to know some of its peculiarities. In this article we will tell you how long it takes to reoperation, how does it differ from the first one.

Need for reoperation

A second birth after a caesarean section does not have to be carried out surgically. If certain conditions are met, a woman may well be allowed to give birth on her own. But no more than a third of pregnant women with a history of one cesarean section do this. The patient's categorical disagreement with physiological birth with a scar on the uterus - this is the first and most compelling reason for repeat surgical delivery.

But even when a pregnant woman dreams of giving birth on her own, she may not be allowed to do so if there are absolute indications for a second operation.

A short or long period of time after the first birth. If less than 2 years or more than 7–8 years have passed, then “reliability” connective tissue uterine scar will cause reasonable concern among doctors. Only 2 years after the birth of the first child, the scar healing site becomes quite strong, and after a long break it loses its elasticity. In both cases, the danger is the possible rupture of the reproductive organ at the site of the scar during strong contractions or pushing.

Complications after a previous birth. If rehabilitation period after surgical birth is difficult: with fever, inflammation, associated infections, hypotension of the uterus, then the second child, with high probability, will also have to give birth on operating table.
Incompetent scar. If at the time of pregnancy planning its thickness is less than 2.5 mm, and by week 35 - less than 4–5 mm, then there is a possibility of uterine rupture during spontaneous childbirth.
Large baby (regardless of its presentation). Multiparous women after a cesarean section can give birth to a baby through natural physiological means only if the expected weight of the child is less than 3.7 kg.
Incorrect positioning of the baby. Options for manually turning the baby for a woman with a scar are not even considered.
Low location of the placenta, placenta previa on the scar area. Even if the “baby spot” edges into the area of the scar, you cannot give birth - only undergo surgery.
Vertical scar. If the incision was made vertically during the first delivery, then independent labor is subsequently excluded. Only women with a strong horizontal scar in the lower uterine segment can theoretically be allowed to give birth independently.

In addition, absolute indications for repeated surgical birth are considered to be irreparable causes that led to the first operation: narrow pelvis, uterine abnormalities and birth canal etc.

There are also relative readings for the second operation. This means that the woman will be offered a caesarean section for her second pregnancy, but if she refuses she may choose natural way delivery. Such indications include:

myopia (moderate);
oncological tumors;
uterine fibroids;
diabetes mellitus

The decision to repeat the operation, if the woman does not object to this method of delivery and there are absolute contraindications, is made when registering the pregnant woman. If there are no contraindications and the woman wants to give birth herself, then the method of childbirth will be chosen after the 35th week of pregnancy at a medical consultation.

Dates

The Russian Ministry of Health strongly advises maternity hospitals and clinics to adhere to clinical recommendations during a caesarean section. This document (Letter of the Ministry of Health of the Russian Federation dated May 6, 2014 No. 15-4/10/2–3190) prescribes the operation after the 39th week of pregnancy. This applies to both first and repeat caesarean sections. The justification is the risk of possible immaturity of the fetal lung tissue up to 39 weeks.

In practice, they try to perform the second caesarean section slightly earlier than first, because independent offensive childbirth, the contractions that appear can pose a threat to the baby and mother mortal danger associated with uterine rupture. Most often, the second surgical birth is performed at 38–39 weeks of pregnancy.

If on scheduled inspection on later the doctor will detect precursors in the woman: the passage of the plug, the readiness and maturity of the cervix, its smoothing, the timing of the operation can be postponed to an earlier time.

By emergency indications During the second pregnancy, surgery is performed at any time to save the life of the fetus and mother. TO emergency situations include prolapse of the umbilical cord, signs of the onset of uterine rupture during gestation, abruption of the placenta ahead of schedule, signs of acute hypoxia and other problems with the fetus, in which it is fatal for it to remain in the mother’s womb.

If a woman is of the opinion that a CS should be done as close as possible to the expected date of birth, then theoretically the operation can be performed (in the absence of contraindications for expectant management) at any time from 39 to 40 weeks.

Preparation

Preparation for the second planned operation begins during pregnancy. A woman with a uterine scar should visit her obstetrician-gynecologist more often than other pregnant women. In the third trimester, it is necessary to monitor the condition of the scar in order to notice in time possible signs its thinning. To do this, it is recommended to do an ultrasound with Doppler every 10 days.

The woman is hospitalized in the maternity hospital in advance. If for the first planned operation you need to go to the hospital about a week before the operation, then for a repeat CS you need to go to the hospital under the supervision of doctors at 37-38 weeks in order to prepare for the upcoming birth.

Doctors prepare in their own way: they must once again examine the pregnant woman, establish the exact location of the scar, its features, take tests, and agree with the patient on the method of anesthesia.

The day before the operation, the anesthesiologist talks with the woman. Premedication begins the evening before surgery: expectant mother in labor They give her a strong sedative (usually a barbiturate) so that she can get as much sleep and rest as possible at night. This will protect her under anesthesia from changes in blood pressure.

On the morning of the operation, the woman’s pubic area is shaved, she is given an enema to cleanse the intestines, and she may be recommended to bandage her legs with elastic medical bandages to prevent thrombosis.

Features of the operation

Main feature repeat cesarean section is that the operation lasts slightly longer than the first. A woman should warn her relatives about this so that they do not worry in vain. Surgeons need additional time to remove the first scar. Each subsequent surgical delivery is carried out along the previous scar. Therefore, situations in which after the first operation a woman had a vertical suture, and after the second there will be a horizontal one, are completely excluded.

If the operation was with a longitudinal incision, then the second time the incision will be made in the same place, excising the old connective tissue so that a new scar can form unhindered. Needless to say, with each cesarean section the scar becomes thinner and thinner, and the risks for pregnancy increase!

If a woman no longer plans to give birth, she can sign a consent form in advance. surgical sterilization. After the baby is removed, doctors begin to tie the fallopian tubes - the onset of a subsequent pregnancy becomes impossible. This simple manipulation can prolong total time which the patient will spend in the operating room for another 10–15 minutes.

Having opened the abdominal cavity, the doctor carefully, so as not to injure, removes it to the side muscle tissue, as well as the bladder. Then an incision is made directly into the wall of the uterus and the amniotic sac with amniotic fluid and baby. The water is drained, the baby is taken out of the incision, the umbilical cord is cut off and transferred to neonatologists. If a woman is not in a state of deep medicated sleep (general anesthesia), then already at this stage she can look at her baby and touch him. This opportunity is provided by such types of pain relief as epidural or spinal anesthesia.

While the mother admires the child or sleeps soundly under general anesthesia, the doctor separates the placenta with his hands, checks whether there are any particles left in the uterine cavity and applies several rows internal seams on reproductive organ. In the final part of the operation, the normal anatomical location of the muscles and bladder is restored and external sutures or staples are applied. At this point the operation is considered completed. The postpartum woman is assigned to the ward for the next few hours intensive care to closely monitor her in the early postoperative period. The baby goes to children's department, where he will be treated, bathed, examined by doctors, and blood tests will be taken from the baby.

How is the recovery going?

The recovery period after a repeat cesarean section also has its own characteristics. A woman’s recovery takes longer than after the first operation, and this is quite natural, because the muscles of the uterus are more stretched, and repeated opening of this muscular organ complicates the postpartum involution of the uterus. After the operation, the uterus remains quite large, but looks more like a deflated balloon or an empty sac. She needs to shrink back to her previous size. This process in involution is considered the most important.

To help the postpartum woman, doctors begin to administer contracting drugs to her from the first hours after transfer from the operating room to the intensive care ward. After a few hours, the woman is transferred to the general postpartum ward, where she is advised not to stay for a long time. It is optimal to get up 10–12 hours after surgery. Physical activity will promote uterine involution. For the same purpose (and not only this!) It is recommended to put your baby to the breast as early as possible. The baby will receive nourishing and healthy colostrum, and the production of its own oxytocin in the mother’s body will increase, which will definitely have a positive effect on the contractility of the uterus.

The woman is prescribed a diet until 4 days after surgery, aimed at preventing constipation and intestinal pressure on the injured uterus. The first day you are only allowed to drink, on the second you can eat broth, jelly, white crackers without salt and spices. Only by the fourth day can a woman eat everything, but avoid foods that stimulate the production of intestinal gases.

Lochia ( postpartum discharge) after the second operation usually end completely by 7–8 weeks after surgery. The sutures are removed 8–10 days after the operation (in consultation at the place of residence), the woman is discharged from maternity hospital in the absence of complications on the fifth day, as in the case of the first surgical birth.

Natural childbirth is the usual way of birth provided by nature. But sometimes, for a number of reasons, giving birth naturally can be dangerous for the life and health of a woman and her child. In this case, doctors solve the problem surgically and resort to a method such as a planned caesarean section. This is the name for a delivery operation, common in obstetric practice. Its meaning is that the child is removed through an incision in the uterus. Despite the fact that it is performed frequently and saves the lives of thousands of children, complications after it also occur.

Sometimes the operation is performed urgently. Emergency surgical delivery is resorted to if complications arise during natural childbirth that threaten the life and health of the child or mother.

A planned caesarean section is an operation that is prescribed during pregnancy. It is carried out only for serious indications. When is a planned caesarean section prescribed, at what time is the operation performed and how to avoid complications?

Indications are divided into absolute, that is, those in which the possibility of spontaneous childbirth is excluded, and relative.

List of absolute indications:

fruit whose weight exceeds 4,500 g;
previous cervical surgery;
the presence of two or more scars on the uterus or failure of one of them;
deformation pelvic bones due to previous injuries;
breech presentation of the fetus, if its weight exceeds 3600 g;
twins, if one of the fetuses is in a breech position;
the fetus is in a transverse position.

List of relative indications:

uterine fibroids;
high myopia;
diabetes mellitus;
the presence of malignant or benign tumors;
weak labor activity.

As a rule, the decision on a planned cesarean section is made if there is at least one absolute reading or a collection of relative ones. If the indications are only relative, it is necessary to weigh the risk of surgery and the risk of complications that may occur in natural childbirth.

When is the operation performed?

At what time a planned caesarean section is performed is decided by the doctor in each specific case, but there are still certain recommended limits. It is necessary to compare the date of the last menstruation, how many weeks the fetus is developed, and what condition the placenta is in.

Based on this information, they decide when exactly to start delivery.

Sometimes doctors in the maternity hospital, when asked by a patient when a planned caesarean section is performed, answer that it is advisable to wait until the first light contractions begin. In this case, the woman is hospitalized in the maternity hospital in advance so as not to miss the onset of labor.

A pregnancy is considered full term when it reaches 37 weeks. Therefore, it is too early to perform surgery before this time. On the other hand, after 37 weeks, contractions can start at any time.

The date when a planned caesarean section is performed is tried to be as close as possible to the expected date of birth. But, since by the end of the term the placenta ages and begins to perform its functions worse, in order to prevent it from developing in the fetus, the operation is prescribed for a period of 38-39 weeks.

It is at this time that the woman is hospitalized in the antenatal department of the maternity hospital to undergo all the necessary tests before the operation.

The surgical method of childbirth is not a contraindication to repeat pregnancies. But if a woman already has a scar on the uterus, it means that the second child will be born in the same way. Monitoring the pregnant woman in this case is especially careful.

A second planned cesarean section is also performed at 38-39 weeks, but if the doctor has doubts about the consistency of the first scar, he may decide to operate on the patient earlier.

Preparing for a caesarean section

It is necessary to prepare for the birth of a baby in this unusual way. Usually, when a planned caesarean section is performed, the pregnant woman is hospitalized a couple of weeks before the expected date of birth.

They will take urine and blood tests from her, determine her blood type and Rh factor, and check the vaginal smear for purity. It is also necessary to monitor the condition of the fetus. For this purpose, ultrasound examination and cardiotocography (CTG). Based on these studies, conclusions are drawn about the well-being of the child in the womb.

The specific date and time of the operation is determined by the doctor, having in hand the results of all tests and studies. Usually everything elective surgeries carried out in the first half of the day. The day before the appointed date, the anesthesiologist meets with the patient to discuss what type of anesthesia will be used and find out if the woman is allergic to any medications.

On the eve of a cesarean section, the diet should be light, and after 18-19 hours it is forbidden not only to eat, but also to drink.

In the morning, a cleansing enema is performed and the pubic hair is shaved. Care must be taken to prevent deep vein thrombosis. For this purpose, the legs are bandaged elastic bandage or they ask the woman in labor to put on special ones.

The patient is wheeled into the operating room on a gurney. On the operating table in urethra a catheter is inserted and removed in the recovery room. Bottom part abdomen is processed antiseptic solution, at the level chest a special screen is installed to block the woman’s view of the surgical field.

Progress of the operation

To reduce anxiety before surgery, it is helpful to know how a planned caesarean section is performed. After administering anesthesia, the surgeon makes two incisions. The first incision is to cut through the abdominal wall, fat, and connective tissue. The second incision is the uterus.

The incision can be of two types:

Transverse (horizontal). Produced slightly above the pubis. With this method of cutting there is low probability that the intestines or bladder will be touched by a scalpel. The recovery period is easier, the formation of hernias is minimized, and the healed suture looks quite aesthetically pleasing.
Longitudinal (vertical). This cut runs from pubic bone to the navel, while providing good access to internal organs. Abdomen cut longitudinally if the operation needs to be performed urgently.

A planned caesarean section, no matter how long it is performed, provided there is no threat to the life of the fetus, is performed more often using a horizontal incision.

The surgeon removes the placenta from the uterus, and the incision is sutured using synthetic materials. In the same way, integrity is restored abdominal wall. Remains in the lower abdomen cosmetic stitch. Afterwards it is disinfected and a protective bandage is applied.

If no complications arise during the surgeons’ work, the operation lasts from 20 to 40 minutes, after which the patient is transferred to the recovery room.

Possible complications and their prevention

Complications may occur during surgical childbirth and in the postoperative period. They do not depend on the period at which a planned caesarean section is performed.

Common complications are the following:

Major blood loss. If a woman gives birth on her own, 250 ml of blood is considered acceptable blood loss, and during surgical delivery a woman can lose up to one liter of it. If the blood loss is too great, a transfusion will be required. The most dangerous consequence of heavy bleeding, which cannot be stopped - the need to remove the uterus.
Formation of adhesions. This is the name for seals made of connective tissue that “fuse” one organ with another, for example, the uterus with the intestines or intestinal loops with each other. After abdominal surgery, adhesions almost always form, but if there are too many of them, chronic pain in the abdominal area occurs. If adhesions form in fallopian tubes, the risk of developing an ectopic pregnancy increases.
Endometritis is an inflammation of the uterine cavity caused by getting into it pathogenic bacteria. Symptoms of endometritis can manifest themselves both on the first day after surgery and on the 10th day after childbirth.
Inflammatory processes in the suture area due to infection entering the suture. If you don't start on time antibacterial therapy, surgery may be required.
Seam divergence. It can be triggered by a woman lifting heavy objects (over 4 kilograms), and the dehiscence of the seam is a consequence of the development of infection in it.

To prevent complications, doctors take measures even before operations begin. To prevent the development of endometritis, the woman is given an antibiotic injection before the operation.

Antibacterial therapy continues for several days after. You can prevent the formation of adhesions by attending physiotherapy and doing special gymnastics.

Recovery period

After childbirth, the uterus returns to its previous state after 6-8 weeks. But recovery period after surgical childbirth lasts longer than after natural birth. After all, the uterus is injured, and the suture does not always heal safely.

In many ways, the recovery period depends on how the planned caesarean section went and how successfully it was done.

At the end of the operation, the patient is moved to the recovery room or intensive care unit. To prevent the occurrence infectious complications, carry out antibacterial therapy.

To relieve pain, anesthetic injections are given. Both general and spinal anesthesia slow down intestinal function, so in the first 24 hours after the intervention it is only permissible to drink water.

But already on the second day you can use it chicken broth with crackers, kefir, yogurt without additives. For 6-7 days you should follow the diet as after any abdominal surgery: no fatty, fried, spicy foods. After this period, you can return to your usual diet.

Constipation is highly undesirable. The use of laxative products is recommended, but if this does not help, you will have to resort to the use of laxatives. If a woman is breastfeeding, the annotation should indicate that use during breastfeeding allowed.

While a woman is in the maternity hospital, her postoperative suture is treated daily.

After discharge, you need to continue to do this yourself with the help of hydrogen peroxide and brilliant green. If the suture festers, ichor comes out of it, or shooting pains appear, you need to tell the doctor about it.

Before deciding that it is necessary to do a planned cesarean section, at what time it is best to perform it, the doctor must analyze all the indications from the mother and child, and also take into account the possible adverse consequences for women's health.

This operation seems simple to many women, but in order for it to go well, the doctor must be highly qualified, and the woman in labor must follow all recommendations regarding the recovery period.

Useful video about planned caesarean section

Replies

Circumstances during childbirth are not always successful. There are times when a baby cannot be born naturally. Sometimes doctors are forced to do everything possible to save the life of the child and mother. In particular, using a caesarean section. Such an intervention does not pass without consequences, and often during subsequent pregnancies, specialists have to prescribe a repeat cesarean section. In what cases can you not do without it and how to prepare for the upcoming procedure?

Indications for surgery

The decision to reoperate is made only after analysis various factors accompanying pregnancy. First of all, the health status of the expectant mother is taken into account - in particular, pathologies such as asthma, hypertension, diabetes, oncology, serious problems with vision, recent traumatic brain injury, deformed or very narrow pelvis, central nervous or cardiovascular systems, the age of the woman in labor is after 30 years.

No less important are the features of the seam from the previous operation. A second cesarean section is performed if there is a longitudinal suture and connective tissue in the scar area, its condition is questionable, and also if there is a risk of divergence of the old suture. Also an indication for surgical intervention is abortion after the first cesarean section.

Pregnancy pathologies are also taken into account: post-maturity, large size or abnormal position of the fetus, weak labor. A second cesarean section is also prescribed if less than two years have passed since the first.

If at least one of the above factors occurs, repeated surgery cannot be avoided. In other cases, the specialist may allow you to give birth naturally.

Dangers of a second caesarean section

After repeated surgical intervention occurs in the pelvis adhesive process, and scars form on the uterus. Unfortunately, modern medicine does not make it possible to avoid such complications. This often leads to bleeding that is difficult to stop. Sometimes, to save a woman's life, a surgeon must perform a hysterectomy (removal of the uterus). As a result, the ability to bear children is lost. Even if you do not resort to such measures, after a second cesarean section the probability of becoming pregnant and carrying a child to term is only 40%.

Repeated surgery carries the risk of damage to the intestines and bladder, since the tissue connections between these organs are disrupted when the first scar heals. Approximately 1/3 of patients experience complications such as inflammatory and infectious processes in the urinary tract. Also, a second cesarean section leads to an increase in morbidity and the development of immunodeficiency in women.

The operation also poses a certain danger for the baby: from the moment the caesarean section begins until the baby is born, more time passes than during the first delivery. As a result, he is exposed to potent drugs for a long time.

In addition, there remains a danger of asphyxia (suffocation) of the baby. During natural childbirth, all vital systems of the newborn are actively launched. This does not happen with a second caesarean section, as the date for the procedure is set earlier than the start natural childbirth.

During observations, it was found that children born by Caesarean method experience certain difficulties in adapting to the environment in the first days of life.

Preparation and recovery after surgery

If you are indicated for planned revision surgery (that is, the need for it was identified during pregnancy), you need to know how to prepare for the upcoming procedure. This will allow you to set yourself up for successful outcome, calm down, put your body and health in order.

Throughout your pregnancy, try to undergo regular examinations with a gynecologist and attend prenatal courses that specifically focus on caesarean section. Prepare yourself mentally for what's to come for a long time be in hospital. Think in advance about who you will leave your older children, house, and pets to during this period. Consider the possibility of having a partner birth. If the operation takes place under local anesthesia, during which you will be awake, you will be more comfortable if your life partner is nearby at this moment. Do not hesitate to ask the doctors any questions you are interested in (at what date is a repeat cesarean section performed, what tests are prescribed, what medications you will need in case of any complications). Find out what kind of anesthesia you will be given. If you want to see the moment the baby is born, ask for local anesthesia.

If you do not go to the hospital by the time of the scheduled date of surgery, prepare things for the hospital: necessary documents, toiletries, clothes and slippers. Two days before surgery, you should stop eating solid foods.

Get a good night's sleep. The day before going to the hospital, take a bath. Removing your nail polish and makeup will make it easier for the doctor to monitor your condition during the procedure. You cannot drink or eat for 12 hours: this is due to the anesthesia that will be used. If you vomit under anesthesia, the contents of the stomach will enter the lungs.

Recovery after a repeat cesarean section not only takes longer, but is also more difficult. The tissues are excised twice in the same place, so they take longer to heal than the first time. The stitch may ooze and be painful for 1-2 weeks. The uterus also contracts longer, causing discomfort.

If you find out you are having a repeat cesarean section, don't panic. Provided you work closely with the doctor, strictly follow all his recommendations and carefully prepare for the operation, it will pass without complications.