Lower segment Caesarean section

Lower Segment Caesarean Section (LSCS) is a type of Caesarean section (C-section) which is the most common method of delivering babies when vaginal delivery would put the baby or mother at risk. This surgical procedure involves making an incision in the lower segment of the uterus to deliver the baby. The lower segment Caesarean section is preferred over the classical Caesarean section due to its lower risk of complications and quicker healing time.

Indications

The indications for a Lower Segment Caesarean Section include but are not limited to:

• Placenta previa: A condition where the placenta covers the opening of the uterus.
• Fetal distress: Signs that the fetus is not well and may not be able to withstand the stress of vaginal delivery.
• Failure to progress in labor: When labor is not progressing as expected, either because the cervix is not dilating, the baby is not descending, or labor has stalled for other reasons.
• Breech presentation: When the baby is positioned to be delivered buttocks or feet first.
• Previous Caesarean sections: Depending on the number and type of previous C-sections, a repeat procedure may be recommended.
• Certain maternal medical conditions, such as active genital herpes or certain types of heart disease.

Procedure

The procedure for a Lower Segment Caesarean Section typically involves:

1. Administration of anesthesia, which can be either regional (spinal or epidural) or general.
2. Making a horizontal (bikini-line) incision just above the pubic hairline. This incision cuts through the skin and abdominal wall to reach the uterus.
3. Making a second incision in the lower segment of the uterus. This incision is usually horizontal but can be vertical in certain circumstances.
4. Delivering the baby through the uterine incision.
5. Removing the placenta and closing the incisions with sutures.

Advantages

The advantages of a Lower Segment Caesarean Section include:

• Lower risk of bleeding and need for blood transfusion.
• Generally, a safer option for future pregnancies compared to the classical Caesarean section.
• Reduced risk of uterine rupture in future pregnancies.
• The horizontal incision in the lower segment of the uterus is less likely to tear in future pregnancies or labors.

Risks and Complications

While a Lower Segment Caesarean Section is generally safe, it is not without risks. Complications can include:

• Infection of the incision site or the uterus.
• Blood loss leading to anemia or the need for a blood transfusion.
• Injury to surrounding organs such as the bladder or intestines.
• Increased risk of respiratory problems for the baby.
• Potential for increased recovery time and pain compared to vaginal delivery.

Recovery

Recovery from a Lower Segment Caesarean Section involves:

• Pain management with medication.
• Avoiding strenuous activity and heavy lifting for several weeks.
• Monitoring the incision site for signs of infection.
• Gradual return to normal activities as advised by the healthcare provider.

Conclusion

Lower Segment Caesarean Section is a common and generally safe method for delivering babies when vaginal delivery is not advisable. It has several advantages over the classical Caesarean section, including a lower risk of complications and a quicker recovery period. However, like any surgical procedure, it carries risks and requires a period of recovery.