How many weeks is a planned caesarean? When is a caesarean section done? Planned and emergency cesarean

Usually, the prospect of a caesarean section (CS) scares women in labor. Nevertheless, the CS allows a woman to know in advance the exact date and time of the birth of the child and to carry out the birth as planned, without any excesses and unpredictable moments. However, many women are interested in why the gynecologist decides that delivery by caesarean section is necessary, and how the optimal time is determined, whether a planned caesarean section will be harmful to the mother and child.

What is a caesarean section?

A caesarean section is an operation in which the baby is removed from the uterine cavity through an incision in the abdominal wall. CS can be carried out as planned, when the woman in labor and doctors know in advance about the operation, and urgently, if for some reason a woman cannot give birth on her own for a long time, and this begins to threaten her health and life.

What is a cesarean

Most often, doctors write in the patient's card not a detailed wording of the referral, but an abbreviation. Therefore, there are often situations when women find out already in the maternity hospital that there will be not a natural birth, but a planned caesarean section, and everything will happen in the coming days. Therefore, it is worth remembering the abbreviations: COP - caesarean section, the prefix "E" to the abbreviation means emergency, the prefix "P" - planned.

Difference between pacemaker and PKC

Since ECS cannot be planned, an experienced gynecologist in late pregnancy may suggest that such an outcome of pregnancy is also possible, but there is still a chance to give birth on your own or higher than expected, then it will be written in the direction that ECS is possible.

If a planned cesarean section is expected, then this will be indicated in the direction, the reasons leading to such a decision will also be indicated, the direction itself will be issued on a specific date. In addition, some referrals are not issued to a specific maternity hospital, but with an open “place”, so that a woman in labor can independently choose the hospital where she will give birth, having previously met with obstetricians and anesthesiologists, and sometimes with specialized doctors, such as cardiologists or traumatologists .

The difference between the pacemaker and the ACL is sometimes seen in how the incision is made. If the birth is very difficult, there are some serious problems, then the doctors do not reflect on the aesthetic appearance of the incision. Accordingly, it can take place anywhere in the abdomen, where it is convenient and as safe as possible. With PKC, the incision usually passes barely above the pubis and is most often hardly noticeable to strangers even without the use of cosmetic sutures.

Elective caesarean section is also safer for subsequent pregnancies and deliveries. Emergency CS, on the contrary, is less safe for women's health. After the pacemaker, a planned caesarean section is almost always prescribed for subsequent births in order to avoid other complications.

Indications for caesarean section

There are not always indications for such operations. But it happens that a woman herself is afraid to give birth, then the expectant mother herself informs the doctors about her desire. Closer to the date when a planned caesarean section is prescribed, you need to carefully prepare.

In addition to personal factors, there are other reasons directly or indirectly related to health. Thus, in the presence of immunodeficiency diseases, cancer, diabetes mellitus, diseases associated with the heart and blood vessels, and in any other diseases that affect the functioning of internal organs, as well as severe edema associated with pregnancy, PCS will be prescribed, and the possibilities A woman will not give birth on her own. Of course, unless the woman in labor hides her illnesses and puts her life and the life of the child at risk.

A planned caesarean section will also be carried out if there are problems with the bones before or during pregnancy. A common cause of PCS is severe separation of the symphysis (symphysitis).

Possible indications may be organs that are not sufficiently prepared for the time of childbirth, for example, an insufficiently opened uterus with already departed waters. Then the doctors decide to administer oxytocin, but if it does not help, an ECS is performed.

In what cases do EX

The EKS is done if the pregnancy proceeded normally, the woman in labor is healthy, the fetus too, but circumstances have arisen that can lead to injuries and other bad consequences. In this case, the operation is performed for a period of 38-42 weeks.

Usually, an ECS is performed if during childbirth the child in the womb began to choke or there were obvious problems with the blood flow in the fetus or mother. In such situations, the COP may be at a period of 36 weeks or earlier. Also, an emergency delivery passes if the water has already broken for several hours, and the uterus has not opened enough for the baby to pass. Most often, such situations occur on terms from 36 to 40 weeks.

There are also cases when the child simply gets stuck in the birth canal. This happens if the fetal head is too large. In this case, doctors are also forced to resort to a pacemaker to eliminate the risks.

Less often, EKS is used when the pregnancy is overdue, when more than 42 weeks have passed since the beginning of the last critical days, as well as when the fetus is incorrectly positioned, for example, with frontal insertion of the fetal head.

At what time do PCS

It is impossible to say unequivocally at what time a planned caesarean section is done, since each woman has her own gestational age. The difficulty in determining the correct term lies in the fact that pregnancy lasts 38-42 obstetric weeks. However, they do not show the actual age of the fetus. If we are talking about natural fertilization, the actual terms may differ from the obstetric ones up to 4 weeks, and this is quite a long time. At the same time, the doctor needs to know how mature the child is, whether his life support systems are working, and even ultrasound cannot show this for sure.

Partly because of the above reason, a planned caesarean section is scheduled at 39 weeks and at a later date, if there are no additional indications, which include circumstances that affect the health of the woman in labor with a longer pregnancy. That is, for some types of diabetes mellitus, a CS is prescribed as early as 36 obstetric weeks, and sometimes even earlier, since it is more profitable for doctors not to risk the life of a woman in labor and a child, removing an already overwhelming burden from a woman’s health and shifting it to devices for further and better development child, thus doctors save many lives.

There are no defined boundaries. When is a planned caesarean section performed? Increasingly, doctors are looking at the underlying circumstances and how the child might be formed. But such conditions work only in the case of natural fertilization.

At the same time, if the insemination was artificial, then from the moment of IVF, doctors will know the timing of the planned caesarean section, if the operation becomes necessary.

How often can PCS be done?

How often can a planned caesarean section be performed and for how long? Can be done multiple times. But you need to remember that CS is an operation on the uterus, the incision from which, of course, heals, but the scar remains. Thus, every second planned caesarean section is another scar on the uterus, which means that after two or three operations, the flexibility and strength of tissues is significantly reduced, there is a risk of premature birth, ruptures and many other problems.

Due to the consequences associated with the deterioration of the uterus, doctors try to resort to CS as little as possible, unless there are any special indications for this. Also, the practice is becoming more widespread when, after PCS, obstetricians try to give birth to a woman in a natural way, and only if the attempt is not justified, they perform an ECS.

There should be at least a year between CS and re-pregnancy. However, it is not uncommon for women to become pregnant within the first six months after a planned caesarean section. The second birth is again a surgical intervention. The CS is repeated again in a year and a half after the first operation, which negatively affects the health of the woman in labor.

How to prepare for PCS

Before starting preparation, you need to find out from the gynecologist how long a planned cesarean section is done in a particular case, when a referral will be issued, and proceed in subsequent actions precisely from the doctor’s decision.

After the gynecologist decides on the indications and the term, he can recommend the most suitable one or give a referral to the specialized maternity hospital, if there is evidence. Usually, in the presence of immunodeficiency diseases in a woman in labor, she is sent to give birth in specialized institutions.

After receiving a referral, a woman can either wait when she needs to go to the hospital, or go to get acquainted with obstetricians and anesthesiologists. The second approach is considered the most comfortable, since a few weeks before the CS, the woman in labor will be told and shown everything, if there are concerns, she can visit other institutions, as well as go to a psychologist. Thus, the stress from the upcoming operation will be reduced.

How does PCS work?

Depending on whether a planned caesarean section and for how long, the complexity of the operation for the child and his mother will depend. Within the standard framework, namely at 38-40 weeks of gestation, PCD passes quickly and without fear for the woman in labor.

During the operation, an incision is made in the abdominal wall and uterus, the child is taken out, the umbilical cord is cut, and the placenta is removed. After that, the fabrics are sutured.

But if the PCS was scheduled for one date, but for some reason the birth began before the CS and complications appeared, then the operation will take longer. It will be associated with other procedures or operations to preserve health and life. But this set of circumstances is incredibly rare, and all because doctors refer women to the hospital one to two weeks before ACL.

Operation duration

It is the operation that lasts from 20 to 40 minutes, but the preparation and subsequent manipulations go beyond this time period. The preparation includes the introduction of anesthesia, disinfection of the place being prepared for the operation, connection of the necessary equipment.

After the operation, the woman may be conscious, or may be under anesthesia. It also has its own nuances. The time of withdrawal from anesthesia is different for each person, while anesthesiologists do not always prefer serious medications, and then during the CS the woman in labor is conscious, although she does not feel pain. In this case, there is no need to withdraw from anesthesia.

Also, the operation often ends with a “refrigerator”, then the woman is taken from the ancestral home to a room where a low temperature is constantly maintained. This is done to exclude possible bleeding. In the "refrigerator" a woman can spend several hours.

Recovery after PCS

If the doctors performed the CS on time, correctly sutured, removed the placenta and did not leave blood clots, then partial recovery after cesarean takes place within two weeks, during which time the woman can already stop experiencing pain and discomfort from the suture, start lifting without problems and outside help child in the arms. Within three months, the seam is already completely overgrown, the discomfort associated with the seam and stiffness of movements disappear, and problems with the stool disappear.

Psychological state after CS can also change as well as physiological. Therefore, after surgery, women are advised to seek the help of a psychologist.

Almost every woman faces the most difficult and at the same time the happiest day of her life. Namely, happy birthday to your baby. Childbirth is considered a natural process that completes the period of pregnancy by freeing the uterine cavity from the fetus and placenta, using the birth canal. Childbirth, which is physiologically considered on time, is if they take place during pregnancy at a period of 37 weeks to 41-42 weeks.

The duration of childbirth is strictly individual. As a rule, in a woman who gives birth for the first time, the duration of labor is slightly longer than in a woman who gives birth again. So, on average, it is considered the norm:

• primiparous women - up to 11 hours;
• multiparous - up to 8 hours.

If the birth lasted less than 6 hours in a primiparous woman, and less than 4 hours in a multiparous woman, then such births are considered fast. Childbirth is divided into several periods:

• the first is disclosure;
• the second - directly the birth of a child;
• the third is the exit of the placenta.

Also, a baby can be born by caesarean section. By caesarean section is meant the surgical intervention of artificial delivery. In this case, the uterine cavity is freed from the fetus and placenta through an incision in the anterior abdominal wall and body of the uterus.

A caesarean section is prescribed when a woman cannot give birth naturally due to medical reasons or in emergency cases. Also, a caesarean section can be prescribed for intrauterine death of a child, with severe bleeding, to save a woman. Indications for caesarean section differ from planned and emergency.

Planned ones include:

• narrow pelvis in relation to the size of the fetus;
• incorrect placenta previa;
• gynecological diseases that can interfere with the natural process of childbirth, these include, for example, uterine fibroids;
• scar on the uterus (after surgery, after caesarean section);
• existing diseases that are not related to pregnancy; these include: pathology of the organs of vision, diseases of the cardiovascular system, urinary-genital system (kidneys);
• severe history during pregnancy - preeclampsia;
• incorrect presentation of the fetus;
• multiple pregnancy;
• infection in the 3rd trimester of pregnancy with genital herpes;
• varicose disease of the lower extremities;
• oncology;
• previous traumatic brain injury.

Emergency indications include:

• sluggish labor activity;
• complete cessation of labor activity;
• premature detachment of the placenta;
• the threat of rupture of the uterine cavity;
• acute fetal hypoxia;
• complications during childbirth that can threaten the life and health of both the woman and the fetus.

Second caesarean section

The second caesarean section is prescribed according to indications, both planned and emergency. As for the first caesarean intervention. These include - the first delivery by caesarean section.

Currently, in medicine, there are more and more cases when a woman after the first caesarean section, during a second pregnancy, childbirth is prescribed in a natural way.

The second caesarean section is prescribed after a thorough examination of the pregnancy history, after a complete examination of the woman. The age of the woman is also taken into account. Recommendations for reoperation are considered:

• age over 35 years;
• features of the postoperative suture;
• the general health of the woman;
• abortions between caesarean and real pregnancy;
• features of the course of pregnancy.

If there are no indications for surgery, then the woman is allowed to give birth naturally.

Is it possible to give birth on my own after the first caesarean section

Currently, it is allowed to give birth independently after the first caesarean section. This requires a thorough examination of the pregnant woman. There are a number of indicators that are favorable conditions for natural childbirth. These include:

• the first caesarean section was at least 3 years ago;
• the scar is completely wealthy;
• the size of the thickness in the seam area is more than 2 mm;
• there are no complications during the observation of pregnancy;
• directly the desire of the woman.

But you should not forget that at present, not all family members are able to carry out delivery in a natural way, after the first caesarean section. That is why, if you want to give birth on your own. Then you need to prepare in advance, talk about this topic with your doctor, and choose a family home that specializes in this issue.

Pregnancy introduction

If you are registered for a second pregnancy, then do not forget that two absolutely identical pregnancies cannot be. Supervision of the second and subsequent pregnancies, after the first caesarean section, is a little different.

Additionally, for a woman, such examinations are introduced as:

• ultrasound examination is prescribed more often than 3 times during the entire pregnancy;
• more frequent diagnosis in the 3rd trimester of pregnancy;
• permanent control of the scar on the uterus.

The introduction of pregnancy is the key to a successful birth

How to prepare

If you already know for sure that you are scheduled for a caesarean section, then you need to correctly approach this moment. Proper preparation will allow you not only to prepare your body for the difficult upcoming operation, but also to prepare yourself psychologically. All these are important facts for a successful operation. For proper preparation, it is recommended:

During pregnancy

• Regularly attend the school of expectant mothers, especially on the topic "Caesarean section".
• Prepare for the fact that after the operation you will be in the hospital for at least 6 days. That is why plan in advance with whom and where you can leave older children. If there are animals, who will take care of them.
• Consider how you will give birth. You may want your husband to be present for the operation. What kind of anesthesia will you be given.
• Visit a doctor regularly.
• Do not be shy and ask the doctor about all your questions.
• You need to agree in advance with 2.3 people. In order for them to donate blood at the blood transfusion station. Since each operation is a risk of bleeding and for this you need donated blood.

A few days before surgery

• Prepare all the necessary things for the hospital for yourself and your unborn child. For myself, this is all standard: a bathrobe, clothes, hygiene items, postpartum pads, breast pads, change of shoes. And for the baby, you need to look at the website of the kind of house where you will give birth.
• For 2 days it is necessary to give up solid food, fried. From food that can lead to bloating.
• Sleep well, relax.
• Do not take any food or water for 12 hours.
• Shave thoroughly.
• Prepare non-carbonated water.
• Fully charge your phone.

Preparation for the second caesarean section makes it possible to put the body in order and prepare it for the operation.

How is the operation

A woman who has already undergone this procedure usually asks: “Is there a difference in the operations of the 1st caesarean section and the 2nd caesarean section?” — No, all stages of the operation remain the same.

Operation steps:

Prenatal period:

• cleansing enema;
• consultation with an anesthesiologist;
• consultation with an obstetrician-gynecologist;
• dressing in special clothes;
• measurement of blood pressure, fetal CTG;
• the nurse examines the pubic area, shaves if necessary;
• a catheter is installed in a vein, a catheter is installed in the urethra;
• administration of anesthesia.

Surgical stage:

• an incision is made along the seam from the previous caesarean section;
• cauterization of torn vessels;
• suction of amniotic fluid;
• extraction of the fetus;
• stitching of the uterus and skin;
• bandaging;
• the introduction of drugs to reduce the uterus;
• applying ice to the abdomen.

After that, sedatives and sleeping pills are usually administered to help the woman relax after the operation.

At this time, the baby is examined by a neonatologist and medical personnel.

Terms of caesarean section in singleton and multiple pregnancy

In this situation, the operation is assigned individually. Since there is always a multiple pregnancy, this is a big risk. Many factors and individual characteristics are taken into account. Basically, the operation is prescribed for a period of 34 to 37 weeks. Usually, doctors do not wait more than 37 weeks. So this is a huge risk that a rapid urgent birth can begin.

In determining the term of the second caesarean section, doctors take into account which week the operation was performed during the first pregnancy - 1-2 weeks are “subtracted” from this value. If for the first time a caesarean was performed at 39 weeks, now it will happen at 37-38.

How is the suture for the second caesarean section

With a planned repeated caesarean section, the seam is made exactly along the seam that was previously. Thus, there will be no visible second seam. But directly the incision of the uterus itself is selected in a new area of ​​\u200b\u200bthe genital organ.

Recovery period

After the operation, the woman is observed in the intensive care unit for 12 hours. After 12 hours, you can already get up and walk. Breastfeeding is allowed after a day. I recommend that a woman put her baby to her breast more often.

1. Every day drugs are prescribed to reduce the uterus. Painkillers are administered 2-3 days after the operation. Drink plenty of plain non-carbonated water.
2. Doctors recommend immediately putting on a postpartum bandage.
3. Every day the gynecologist examines you, palpates the stomach.
4. On the 5-6th day, the bandage is removed, the seam is examined, an ultrasound is done, and then it is decided when to prepare you for discharge.

Uterine discharge continues up to 1-2 months after childbirth. After discharge, it is recommended to see a gynecologist after 10 days to examine the suture. And after 1 month, make a control ultrasound of the pelvic organs.

If you have a fever after discharge from the hospital, the discharge began to increase, then you should immediately consult a doctor.

Possible Complications

With each new operation, the risks of complications increase. But this does not mean that they will necessarily be. Complications can occur both after the first and after the second caesarean section. They do not differ from each other.

Complications include:

• scar divergence;
• adhesive process;
• poor contraction of the uterus;
• inflection of the uterus;
• inflammatory process of the pelvic organs;
• big blood loss;
• endometritis.

The most common operation in obstetrics today is a caesarean section. Over the past decades, doctors have improved their technique, but there are differences between a planned operation and an urgent one to this day.

Birth by caesarean section - the appearance of the method in obstetric practice

There is one version that the name of the operation appeared in practice because of Julius Caesar: he was born with the help of a dissection of the abdomen, for which the manipulation got its name. It is believed that this is the first child who was born during an obstetric surgical operation.

However, this surgical operation found its application in medicine only two millennia later, with the advent of anesthesia and the improvement of surgical techniques. Prior to this, obstetric forceps were used for a long time at the birth of children.

The cesarean section operation began to be used only in the second half of the last century, when antibiotics were invented, and began to develop actively in medicine. With the advent of new opportunities in medicine, serious complications after operative childbirth have decreased. With the help of blood transfusion, the problem arising from large blood loss was solved, and with the advent of antibiotics, bacteria that cause inflammation in the uterus and in the peritoneal cavity (obstetric peritonitis) were fought.

Currently, universal types of anesthesia are used - for example: it is practically safe, and is increasingly used for caesarean - both planned and emergency.

Indications for caesarean section in a planned or emergency order

A caesarean section is used when a woman cannot safely give birth to a child naturally.

The indication for such an operation is the anatomical structure of the pelvis of a woman- it is narrow, or a large baby is expected.

Sometimes in childbirth there is a threat to the health of the pregnant woman and the baby, and possibly their lives.

Usually, a planned caesarean section is prescribed, when adverse situations are foreseen in advance, and there are contraindications for natural childbirth. If the course of pregnancy is normal, then natural childbirth is expected.

But it happens that the situation already in the birth itself changes for the worse - then there is a need to urgently apply a caesarean section.

In law!

Before an operation is performed on a future mother, both planned and emergency, the Law provides for obtaining her written consent to surgery.

If a pregnant woman is unconscious, then the doctor can make a decision on her own.

Surgical tactics for performing a caesarean section

With an urgent operation, and with a planned approach, the approaches are the same: an incision is made on the uterus, through which the child is removed, and then the afterbirth.

But the tactics for surgical intervention are different.

Currently, doctors perform cutaneous and uterine transverse smile cut between the womb and the navel. Such a cut has an aesthetic effect, it will be hardly noticeable under the linen. Also, the lower segment of the uterus is dissected by a transverse incision, it affects the connective tissue without damaging the muscles of the uterus. Well healing, the seam in this place resolves almost completely.

Also do longitudinal section above the womb perpendicular to the umbilicus. Such a seam is much easier to perform, therefore, with urgent intervention, the doctor must use this method. But today, many Russian surgeons are highly qualified, and therefore, in an emergency, they can make a transverse incision easily and quickly.

Due to the fact that the longitudinal incision dissects the muscles of the uterus, the suture heals for a long time, and the scar remains until the end of life. With repeated births, uterine rupture may occur, because of this, natural childbirth will subsequently be prohibited.

When using a transverse incision, the chance for a subsequent natural birth is preserved.

Approaches to caesarean section

The uterus is dissected using different incisions. Surgeons often open a thin film of the peritoneum, which covers the abdominal cavity from the inside, protecting against infection of the uterus. This caesarean section is called intraperitoneal.

This method has a minus, the risks of infection of the peritoneum increase, but with the advent of new generations of antibiotics, operations have become more successful.

There are rare cases when the anhydrous period lasts a long time, then they spend extraperitoneal cesarean. There is a small area, it is not covered by the peritoneum, and is located near the fallopian tube - through it they get to the uterus. In this case, the abdominal cavity is not cut, so infections are less introduced. But such an extraperitoneal operation is too technically complicated, so it is rarely done.

Growing popularity of caesarean section – is operative delivery always justified?

In recent decades, there have been three times as many caesarean sections: today, thirteen out of a hundred babies are born in this way.

In the future, this trend will continue, as many women give birth to their first children after 30 years. At this age, childbirth is often complicated, so it is necessary to do a caesarean section.

When there are not enough female hormones, weak labor activity is formed.

Women who have already had a caesarean section change the statistics upwards. The second child will see the light in the same way as the first, with the help of an operation - if a paid contract was not concluded for the birth.

Indications for a planned caesarean section - everything is going according to plan

Elective caesarean shown when the fetus lies across, with an anatomically narrow pelvis of 2-4 degrees in a woman, with the failure of a postoperative scar on the body of the uterus after a previous cesarean, with placenta previa, which was detected by ultrasound, with fetoplacental insufficiency, with severe myopia, which is accompanied by changes in the eye bottom, thinning of the retina.

If a boy is expected to be born, but he has one, then this is a reason for a caesarean section due to the fact that a scrotal injury can form during natural childbirth.

Another weighty argument is pregnancy with complications after a period of infertility or in cases of in vitro fertilization. A caesarean section is used to minimize the risk of having a baby.

If a woman suffers from diabetes mellitus, heart defects, kidney diseases, severe hypertension, then the obstetrician-gynecologist agrees with the therapist on the method of childbirth.

A planned operation is being performed at 38 weeks pregnant. By this time, the child is already fully formed, and ready to be born. If there are strong indications - for example, a severe Rhesus conflict, the development of severe hypoxia that cannot be treated, then the operation is performed earlier.

The expectant mother is hospitalized in the observational department for pregnant women in the maternity hospital. The date of the operation is determined after examinations, such as a blood test, ultrasound, cardiotocography.

A planned caesarean section has a major plus - you can fully prepare. The day before the operation, a pregnant woman is prescribed a light diet, which consists of a light breakfast, lunch, and only tea with sugar is allowed for dinner. After shower procedures, a cleansing enema is given to a woman, in the morning she is put again. Such measures are taken so that intestinal paresis does not develop, the possibility of which appears after surgery with stagnation of fecal masses. Microbes that are in the intestine are able to enter the abdominal cavity through the intestinal wall, leading to obstetric peritonitis. This route of infection of the peritoneum is very common, although there are others.

In order for the expectant mother to sleep well before the operation, she is prescribed a safe sleeping pill at night.

And when planning a caesarean section, a woman is psychologically adjusted. With this attitude, the expectant mother and baby will be less stressed, which will have a positive effect on the operation itself, on the rehabilitation period after the operation.

Emergency caesarean section - at a fast pace

If there is a threat to the life of the expectant mother or her child, then an emergency caesarean section is used. This is also used during pregnancy, and during the period of natural childbirth that has begun.

When a placental abruption begins prematurely in a pregnant woman, this leads to sudden bleeding, so an emergency CS is resorted to.

In childbirth, it is carried out when complications suddenly develop, manifested by weak labor, bleeding, the threat of uterine rupture, and acute fetal hypoxia. But, if the baby's head should soon appear in childbirth, then it will be difficult to remove it through an incision made on the body of the uterus. In such cases, doctors use obstetric forceps, or use a vacuum extractor.

Emergency caesarean section is performed at different times of the day. Preparation for the operation is not carried out due to lack of time, therefore increased risk of infectious complications after surgery, for the prevention of which antibiotic therapy is carried out.

It is impossible to give an exact answer at what specific time period a planned caesarean section is performed. In each case, the woman determines the optimal time for the operation on her own. More precisely, not so much the expectant mother as the child - the onset of labor activity is the best evidence of the readiness of the crumbs to leave the mother's womb.

But it was not always so. For decades, in domestic medicine, the first planned caesarean section has been practiced at a specific time for all cases - after 40 weeks of pregnancy, that is, a full cycle of gestation. Today, doctors everywhere are moving away from this approach, since it does not provide benefits, and the likelihood of complications only increases.

How is a planned caesarean scheduled?

Only the doctor decides on the need for delivery by means of an incision on the uterus. Moreover, it can become known both quite early, even before the rounding of the tummy, and shortly before childbirth. Women who are scheduled to have a caesarean section are monitored with particular care.

It is normal practice when the doctor determines the expectant mother to the hospital about a week before the baby is born. With constant monitoring in the hospital, the risks of needing an emergency cesarean, fraught with complications, are minimal.

More often, you will have to lie down on the operating table with the onset of the first, weak contractions. In most cases, this is 39-40 weeks. At this time, a number of problems are solved - hormonally, the woman's body is already ready for breastfeeding, the baby's lungs easily adapt to new conditions.

Second planned caesarean

Although the first operation does not exclude the possibility of carrying and giving birth to a healthy child in the future, a repeated caesarean section is accompanied by a number of difficulties. Firstly, it is somewhat more difficult for the expectant mother to endure pregnancy. Secondly, the risk of a suture divergence from a previous operation is significantly higher after 39 weeks, which requires special attention from doctors.

For this reason, pregnant women are placed in the hospital a little earlier - to preserve the fetus. It is even more difficult to say exactly how long a planned caesarean section is, if it is the second in a row. The reference point is the same - 39-40 weeks. But, as a rule, doctors prefer not to delay, do not wait for the onset of labor - the operation is prescribed in the period from 36 to 39 weeks.

The second cesarean also involves a more complex process of making an incision on the uterus. Since during a planned operation it is necessary to cut horizontally, the new seam will have to be on the old one, on top of it. Scar tissue is more durable, rough, and the likelihood of damage to internal organs - the bladder of the intestine - increases. In most cases, stronger anesthesia is prescribed.

The second operation in a row is a big burden on the female body. At what time to do the first and second planned caesarean section, doctors determine, trying to minimize the risks of subsequent complications. Doctors strongly discourage mothers from trying to conceive again after two births.

In anticipation of the touching moment of meeting her baby, every woman wants to know the date of birth in advance. This will provide an opportunity to prepare, collect a “disturbing suitcase” for the hospital and tune in psychologically. Let's figure out how many weeks a caesarean is done.

Cesarean section is planned and emergency. Indications for it occur both during pregnancy and during childbirth.

The date of the operation will depend not only on you, but also on the hospital where you are going to give birth. After all, each clinic has its own rules. One thing is for sure, they do a planned operation during a full-term pregnancy or as close as possible to this period.

Ideal if you have a planned operation. At the same time, mother and baby feel good, nothing threatens their condition. In such a situation, you can perform a caesarean section with the onset of contractions.

For the baby, this is very good, since childbirth will begin only when your baby is ready for birth and fully mature for this.

In addition, it will have a positive effect on breastfeeding.

Such a situation is possible, for example, in diseases of the eyes, the skeletal system, if the size of the mother’s pelvis is smaller than the circumference of the child’s head, if the mother had ruptures of the rectum in previous births, there are tumors of the uterus (myoma), vagina, pelvic bones that interfere with natural childbirth.

In these situations, a planned caesarean section can be performed with the onset of labor at 38-41 weeks. But the doctor of the antenatal clinic will send you to the maternity hospital in advance, in the period of 38-39 weeks.

This is necessary in order to pass tests and perform additional examinations, if necessary.

In most maternity hospitals, they prefer not to wait for the onset of labor, but to schedule a cesarean date after the patient is hospitalized. In this case, they will try to perform the operation closer to 40 weeks.

By the way, if you like any number, you can ask the doctor to schedule an operation for that day. Your wishes will be taken into account, if possible.

What week is the operation done?

It depends on the specific obstetric situation.

• With breech presentation of the fetus. You will be hospitalized in advance, at 38-39 weeks. After weighing all the pros and cons, they will make a decision: caesarean or natural childbirth. If you have a caesarean section, then it is better to wait for contractions. Of course, if there are no other indications, so as not to delay the operation. The child can roll over on the head at the last moment and the need for surgery will disappear. Especially if the pregnancy is repeated.
• With the transverse position of the fetus, the caesarean will be done on the scheduled date, before the onset of labor. The fact is that when the water is poured out, small parts of the child can fall out - the umbilical cord, pens.
• Complete placenta previa. The placenta completely covers the birth canal. Such a pregnancy is very difficult to endure because of the risk of bleeding. With the onset of contractions, the cervix opens and bleeding may begin due to placental abruption. Therefore, such women are operated on for 38 weeks. But if bleeding starts, you will have to perform emergency surgery earlier.
• If you are having a second caesarean or a third and subsequent, then the date of the operation will depend on condition of the scar on the uterus. In the third trimester, the fetus grows rapidly, and the scar may not withstand the load. If the scar is thinned and overstretched, you are worried about pain in the lower abdomen, then they will not wait long. They can also operate at 37 weeks, especially if the operation is the third or fourth.
• Not many people know that multiple pregnancy considered full term at 36-38 weeks. Twins can be born through the natural birth canal. But identical twins, as well as fraternal twins, when the first child lies on his booty or across, twins after IVF - are born by caesarean section. If there are three or more fruits - only caesarean. It is much harder to carry twins and there are more complications during pregnancy. They try to perform a planned operation closer to the 38th week. But, if something goes wrong, one of the children lags behind the other in growth and development, a cesarean can be done earlier, at 34-35 weeks, especially if the twins are identical.
• HIV-infected women are scheduled for caesarean at 38 weeks.
• After cervical surgery you, too, are waiting for a planned caesarean section, before the onset of labor. This is necessary so that the neck is not damaged when contractions begin.

When is an emergency caesarean?

Indications for an emergency caesarean section can occur at any time, even with premature pregnancy, i.e. before 37 weeks. If in the period from 28 to 34 weeks childbirth begins, or there are indications for the birth of a child prematurely, then a caesarean section is performed. The child is not mature and childbirth through the birth canal is too difficult for him.

An emergency caesarean section is performed before 37 weeks if:

1. Bleeding begins due to premature detachment of the placenta.
2. Bleeding with placenta previa.
3. When there are signs of uterine rupture along the scar. Especially if there is more than one scar on the uterus.
4. Another reason is fetal hypoxia. The child receives less nutrition and oxygen from the mother. If this condition continues for a long time, then the baby may die. To save a child, you have to give birth and nurse him in an incubator, even if the gestational age is still small.
5. If from 22 weeks of pregnancy you are tormented by edema, high blood pressure, poor urine tests - this is preeclampsia. With the growth of the gestational age, it becomes more and more difficult to treat it, the child also suffers from edema of the mother and lags behind in growth. If the condition of the woman and the fetus deteriorates sharply, then a caesarean section is performed at any time.

A caesarean section can also be done in childbirth, which will begin on its own.

• Clinically narrow pelvis- when the size of the mother's pelvis and the size of the presenting part of the child do not correspond to each other and childbirth is impossible. It becomes clear only in childbirth.
• frontal presentation- when the head enters the pelvis with the largest size. Her birth through the natural birth canal becomes impossible.
• Prolapse of the umbilical cord after rupture of amniotic fluid.
• hypoxia fetus may develop during childbirth. In this case, the birth must be completed immediately so that the child does not suffer.

There is also a small caesarean section. It is performed at the gestational age of 13-22 weeks in order to terminate it. It is performed if the placenta completely blocks the entrance to the uterus. Or there is placental abruption and bleeding, which requires emergency care for the woman.

As you can see, indications for caesarean section can be very different and occur at any time and at any time. Therefore, as soon as you go on maternity leave, collect a “disturbing suitcase” that will contain everything you and your baby need.

Fetal passport and your passport, shirt, gown, disposable diapers, spoon, mug, personal hygiene products: comb, pads, toothpaste and brush, toilet paper, intimate hygiene gel or soap. For the baby, diapers, powder, diapers, suits.

No matter how long a cesarean is performed, the main thing is that it be done according to indications and preserve the health of the expectant mother and child.

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In recent decades, more and more babies are born by caesarean section (CS). In some maternity hospitals in the CIS countries, CS rates reach 50% of all births. In 2005, WHO conducted studies showing that with an increase in the frequency of CS, the frequency of prescribing antibiotics in the postpartum period increases, as does the level of maternal morbidity and mortality. On average, caesarean section occurs in 15 births out of 100, while a further increase in the frequency of CS does not lead to a decrease in perinatal morbidity and mortality in children.

Given the relatively high frequency of CS, any opportunity to reduce the risks associated with operative delivery will have significant benefits both for individual women in labor and in terms of economic costs.

Compared with vaginal delivery, maternal mortality rates for CS (40 per 10,000 cases) are 4 times higher than for all types of vaginal births, and 8 times higher than for normal vaginal births (5 out of 10,000 cases).

Planned caesarean section

A caesarean section can be performed when the doctor, together with the woman in labor, decides in advance on operative delivery, as the safest method of delivery, or urgently, when there are indications for urgent operative delivery. Even when registering, an obstetrician-gynecologist collects an anamnesis of a pregnant woman. Based on this information, he decides on the type of delivery recommended for this woman. Indications for a planned caesarean section can be both on the part of the mother and on the part of the fetus.

These include the following states:

From the mother's side:

Placenta previa, which is confirmed by ultrasound after the 36th week of pregnancy (the edge of the placenta is less than 2 cm from the internal os);

A scar on the uterus in the presence of contraindications to subsequent vaginal delivery:

• The presence of any contraindications to vaginal delivery;
• Previous corporal CS;
• Previous T and J-shaped incision on the uterus;
• History of uterine rupture;
• Any previous reconstructive surgery on the uterus, resection of the uterine angle, hysterotomy, myomectomy with a history of penetration into the uterine cavity, laparoscopic myomectomy in the absence of uterine suturing with modern suture materials;
• More than one CS in history. As an exception, vaginal delivery is allowed in women who have undergone 2 CSs, if there is at least one vaginal delivery in history;
• A woman's refusal to attempt vaginal delivery;

HIV-infected women:

• women taking three antiretroviral drugs and having a viral load of more than 50 copies per 1 ml;
• women taking zadovudine monotherapy;
• Women infected with HIV and hepatitis C at the same time.

in such cases, the COP is indicated for a period of 38 obstetric weeks, before the rupture of the membranes;

The appearance of genital herpes for the first time 6 or less weeks before delivery;

The presence of extragenital pathologies (the diagnosis must be established or confirmed by a specialized doctor):

• from the side of the cardiovascular system - arterial hypertension of the III degree, coarctation of the aorta (without surgical correction of the defect), aneurysm of the aorta or other large artery, systolic dysfunction of the left ventricle with ejection fraction
• ophthalmic - hemorrhagic form of retinopathy, perforated corneal ulcer, wound of the eyeball with penetration, "fresh" burn. Other pathologies of the organs of vision are not an indication for CS;
• pulmonological, gastroenterological, neurological pathologies in which the attending physician recommends childbirth by CS;
• Tumors of the pelvic organs or the consequences of a pelvic injury that prevent the birth of a child;
• Cervical cancer;
• Conditions after rupture of the perineum III degree or plastic surgery on the perineum;
• Conditions after surgical treatment of urogenital and enterogenital fistulas;

From the side of the fetus:

• Breech presentation of the fetus after the 36th week;
• Breech presentation or incorrect position of the fetus in multiple pregnancies;
• Transverse presentation of the fetus;
• Monoamniotic twins;
• Syndrome of growth retardation of one of the fetuses in multiple pregnancies;
• Gastroschisis, diaphragmatic hernia, spina bifida, teratoma in the fetus, fusion of twins - subject to the possibility of providing prompt assistance to a newborn child;

COP at the request of a woman in the absence of the above indications is not carried out. There are discussions about this in medicine. On the one hand, women want to decide on their own how to give birth to a child, and on the other hand, a caesarean section is an operation and is associated with many risks for the mother and fetus. If a woman refuses the indicated operation, she must sign an informed refusal with her own hand.

Scheduled caesarean section

Perform after a full obstetric 39 weeks of pregnancy. This is due to the minimization of respiratory distress syndrome (RDS) in the newborn.

In the case of multiple pregnancies, elective CS is performed after 38 weeks.

In order to prevent vertical transmission of the disease in case of HIV infection of the mother - at 38 weeks of pregnancy, before the discharge of amniotic fluid or before the onset of labor.

In case of monoamniotic twins, the operation of the CS should be performed at a period of 32 weeks after the prevention of fetal RDS (special injections are made to help open the lungs).

Our life is changing every day. Both medicine and science are developing rapidly, saving and making life easier with the help of new technologies. We are spared from many of the problems that existed before. But the main thing does not change - we continue to love, hope, give birth and raise children. In our life, the birth of a child is always the most amazing and significant event.

Pregnancy- a physiological process, not a disease, many doctors say. However, during this period of a woman's life, a woman's health is tested for strength, she needs to go through increased stress, which makes her more sensitive and vulnerable. Childbirth is also not a pathological condition, but a necessary difficult process, which ends with the birth of a baby. But it is a huge stress for both and sometimes requires special medical attention.

There is no common opinion among doctors about the only correct, safest and most painless way of childbirth, especially for healthy women with a normal pregnancy.

Every woman has the right, and now the opportunity, to choose the optimal and safest delivery option for herself and her child, chosen together with her supervising doctor and approved by him in accordance with all the indications that arose during pregnancy.

But there are situations when an obstetrician-gynecologist unambiguously or weighing the risks insists on a caesarean section - a surgical operation that allows the child to be born by removing it from the mother's abdomen, who cannot or cannot give birth to him in the usual way.

Reasons for the increase in the frequency of caesarean section

An increase in the number of women who decide to give birth only after 30 years in combination with possible gynecological pathologies (adnexitis, endomyometritis, neuroendocrine disorders, infertility, operations on the uterus and appendages, uterine fibroids, endometriosis, etc.).

Frequent pregnancy against the background of various other non-gynecological diseases, when pregnancy occurs with complications. Often there is a complicated course of childbirth.

Improving the diagnosis of pathology during pregnancy due to new research methods that allow for a more accurate diagnosis.

Expansion of indications for caesarean section in severe preeclampsia, premature pregnancy, breech presentation of the fetus.

Expansion of indications for caesarean section performed in the interests of the fetus.

The ability to avoid the imposition of obstetric forceps.

Most of the pregnant women who have previously had a caesarean section, who are not recommended to give birth on their own.

Despite all these reasons and indications, experts unanimously recommend that if it is possible to give birth on their own, then there should be no talk of any cesarean section, since the risks for both the mother and the child during cesarean section are not at all lower, and often higher than in natural childbirth.

Indications for caesarean section

A cesarean section has to be resorted to when the pregnancy is complicated and natural childbirth becomes dangerous. Well, if the obstacles are detected long before the birth, then the doctor can plan the operation in advance and prepare the woman in labor. In this case, the caesarean section is called planned. But sometimes it happens that a woman begins to give birth normally, but something goes wrong and the situation becomes dangerous. In this case, an emergency operation is performed.

A caesarean section is performed only on doctor's orders. It is good if the expectant mother weighs all the pros and cons and turns to several specialists. As a rule, artificial delivery is offered to pregnant women for several reasons. Indications for a planned caesarean section may include the following.

Indications for a planned operation

For these reasons, even during pregnancy, the doctor may schedule a caesarean section:

Indications for emergency caesarean section

These are any complications during childbirth that disrupt their normal course and threaten the life and health of the mother and baby.

Methods of anesthesia for caesarean section

There are general (endotracheal) and regional (epidural or spinal anesthesia) methods of pain relief for caesarean section.

Endotracheal anesthesia immerses the woman in labor in a drug-induced sleep, and anesthesia is carried out into the respiratory tract (trachea) through a tube. Therefore, it is called endotracheal. General anesthesia works faster, but after waking up it often causes unpleasant consequences: nausea, pain in the shoulders, burning, drowsiness.

An epidural is an injection into the spinal canal. Only the lower part of the body is anesthetized. During the operation, the woman in labor is conscious, but does not feel pain. You won’t have to see the whole process - the health workers will hang a special screen at the level of the pregnant woman’s chest. After the anesthesia has worked, the doctor carefully cuts the abdominal wall, then the uterus. The baby is taken out after 2-5 minutes. As soon as the baby is born, the mother can see it and attach it to the breast. An epidural operation lasts about 40-45 minutes and, first of all, is suitable for mothers who are worried that under anesthesia they will not feel their “participation” in childbirth and will not be able to see their babies first ...

Consequences of caesarean section

A caesarean section increases the risk of serious problems with anesthesia, infection, and bleeding. A longer hospital stay will be required. There are pains weeks after delivery and difficulties in caring for the newborn and other children, more pain medication will be needed, antibiotics and blood transfusions are more likely than after childbirth through natural routes. It is not so soon possible to return to household duties or to work. Moreover, the financial costs are much higher than with natural childbirth.

Babies born by caesarean section have more trouble breathing and keeping warm, especially if they haven't had any contractions at all. Even when compared to prolonged or difficult vaginal births, this additional risk exists.

When deciding whether to have a caesarean section, you and your doctor must weigh the risks and benefits. The risk of a caesarean section only pays off in situations where vaginal delivery could put the mother or baby at even greater risk.

A caesarean section, also called "Roman birth", is an operation during which the woman's abdomen and uterine wall are cut, after which the baby and placenta are removed. The reasons for such an operation can be many factors, but for how long a planned cesarean is done, the attending physician decides.

A planned cesarean section is usually not done before 38 weeks of gestation, since it is believed that, starting from this period, the child becomes viable. In rare cases, a planned cesarean may be scheduled before 38 weeks of pregnancy, which is associated with factors due to which a woman in labor cannot wait for contractions and push. In any case, a woman undergoes special training for surgery, which will reduce operational risks and simplify the postoperative period.

Reasons for caesarean section

A planned caesarean section is prescribed in cases where natural childbirth is dangerous due to a high degree of threat to life and health for a woman in labor or a baby.

Reasons for the impossibility of natural delivery:

Sometimes a planned caesarean section is prescribed due to a combination of two or more factors.

When do I need to go to the hospital for a planned caesarean?

While the observation lasts, the doctor, relying on factors that prevent natural childbirth, speaks with the patient about the need to perform a planned caesarean section, no one makes a secret of this. Moreover, the doctor will explain in detail the reasons for which the caesarean section is scheduled, how long the operation will last, discuss the preparation and timing of its implementation.

If the pregnancy proceeds normally, then the patient enters the maternity hospital for a period of 36-37 weeks, then it is observed by specialists, and, if indications for surgery are still present, an operation is performed at a period of 38-39 obstetric weeks of pregnancy.

In the case when there is a threat of termination of pregnancy, the patient is sent to the maternity hospital for a period of 33-34 weeks or earlier, if necessary. In the maternity hospital, therapy is prescribed aimed at maintaining the pregnancy, and then an operation is performed, also for a period of 38-39 weeks.

In exceptional cases, a planned operation may be scheduled for a period of 36 weeks. This happens when the patient, due to various circumstances, cannot wait for contractions.

Operation

Anesthesia used during caesarean section:

• Epidural anesthesia - an anesthetist injects an anesthetic into the epidural region of the spine, resulting in a temporary blockade of the nerve endings, and the patient does not feel pain from the operation, but is conscious and can see and hear her newborn baby.
• Spinal anesthesia - similar in action to epidural, the main difference is that the anesthetic is injected into the spinal region of the spine and causes blockade of the spinal cord.
• General anesthesia - in modern medicine, it is used as a kind of exceptional measure when the patient has intolerance to local anesthesia. Such anesthesia affects the born child, he is lethargic, sleepy, in addition, under the influence of general anesthesia, a woman is deprived of the opportunity to immediately see her baby, hear his first cry.

During the operation, the tissues of the peritoneum and uterus are horizontally dissected, the baby is removed and the umbilical cord is cut. Then the baby is washed, mucus and amniotic fluid residues are removed from the nose and mouth. In the meantime, the placenta is removed, several stitches are applied and the operation is completed. The duration of the operation is on average about half an hour. Since viable infants are removed during elective surgery, it is usually not necessary to place them in an incubator.

Then the woman stays in the postoperative ward under supervision during the day. She is prescribed painkillers and uterine contraction medications, as well as the introduction of blood-substituting solutions, making up for the blood loss that occurred during the operation.

In the normal course of the postoperative period, the patient is transferred to the postpartum department, where she is already together with the baby. For a few more days, she is given painkillers and reducing injections, they monitor the state of the seam, treating it daily with antiseptics.

Postoperative period

How long a woman in labor will be in the hospital after the operation is decided by the attending physician who monitors her condition. As a rule, on the 5-7th day, a woman is discharged home. She is prescribed a special diet to restore normal bowel function, two months of sexual rest and no physical activity for up to six months.

Complications associated with the operation:

After the operation, the doctor prescribes several ultrasound examinations, the first of which is two months after the operation.

Ultrasound will show how the suture heals and the operated areas are restored. It is believed that in 2-3 years the female body undergoes a complete recovery after surgery, and it is better to plan a subsequent pregnancy at least 3 years after cesarean.

By following the doctor's instructions, as well as regularly visiting the gynecologist to examine the seam, a woman will minimize all possible risks and complications associated with a caesarean section.

A caesarean section can be emergency and planned, that is, carried out at a predetermined time or earlier than this time, or even for a woman who did not have this operation planned. What to expect from operative delivery? How is a woman prepared for it? What are the difficulties in restoring the body after surgery? And what are the reasons for a planned caesarean section?

Usually, about a possible operation, if there are any grounds for it, a woman will know in advance, a few weeks before the expected date of onset of labor, from the doctor of the antenatal clinic leading her pregnancy. However, whether there will be an operation or not, the question is not decided by him. And it’s not the doctor who writes out a referral to the hospital so that his patient is scheduled. From the doctor leading the pregnancy, only a referral to the maternity hospital is required, namely, to the department of pathology of pregnancy. The question of the operation, its necessity, timing, anesthesia is taken directly by the doctors of the maternity hospital.

Usually, a planned cesarean is done at a time as close as possible to the expected date of birth. But without special indications not on weekends or holidays. This is especially true in the conditions of small maternity hospitals in small towns, where there are no anesthesiologists constantly on duty in the maternity hospital.

Upon admission to the department of pregnancy pathology, a woman is carefully examined. Even if she had already taken urine and blood tests before hospitalization, she would definitely retake everything. In addition to general tests, they take blood from a vein for HIV, RW (syphilis), hepatitis, biochemical analysis, sugar, blood group and Rh factor. For a long time, especially with low blood pressure, in the morning, on an empty stomach, when donating blood from a vein, a woman may become ill. If you were already unwell at the time of blood donation, ask the nurse to take her sample from you in a supine position, on the couch. Eat a piece of chocolate right after. It will quickly restore your vigor.

Preparing for a planned caesarean also includes going around different doctors. Necessarily ophthalmologist, therapist, otolaryngologist. An ECG is performed the day before surgery. An interview with an anesthesiologist. If hospitalization is carried out a few days before the operation, a woman may be given a dropper with saline. This is necessary to saturate the body with fluid, because during surgery a large blood loss is expected. This liquid will go to replenish it. In addition, as a standard, women are given intravenous injections of Piracetam, a drug that improves cerebral blood supply.

In the evening before the operation, the woman is given an enema. Bowel cleansing is repeated in the morning. A catheter is placed in the bladder. Well, then, the work of doctors and honey. sisters. How a planned cesarean operation goes - how successful it is depends on them, well, on the individual health characteristics of the woman in labor and the course of her pregnancy. The woman is given spinal (epidural) anesthesia or endotracheal (general) anesthesia. The incision of the peritoneum is usually performed in the lower segment of the abdomen, transverse, rarely vertical. The second heals worse and gives more complications. Therefore, it is performed only when it is carried out, especially in case of premature pregnancy, or planned, but with a life-threatening condition of the woman in labor or the child. This type of incision is bad for its unaesthetic and long-term healing. This not only reduces the quality of life of a woman in the first months after surgery, but also negatively affects the onset and course of the next pregnancy. So, complications after a planned caesarean section in the form of an inconsistent scar on the uterus, in the case of a horizontal incision, are rare. True, not only the type of incision plays a role here, but also the operation and the postoperative period.

Thus, the following emerge pros and cons of a planned caesarean.

• no labor pain;
• there is no fear that the child will have a birth injury;
• no ruptures of the perineum, cervix.

• prolonged, healing of sutures and problems in the form of hernias and other surgical complications;
• problems with the establishment of breastfeeding (due to the untimely application of the child to the breast and its rare sucking);
• often developing endometritis (inflammation of the uterus), requiring antibiotic treatment - common consequences of a caesarean section;
• possible divergence of the scar during the next pregnancy;
• postoperative pain;
• the need to use contraception, pregnancy planning not earlier than two years after surgery.

Indications for a planned caesarean section and the timing of its implementation

There are many reasons why doctors may decide to operate on a woman. These are just some of the most common ones.

1. Clinically narrow pelvis. This is the case when there is a very strong narrowing of it. The doctor clearly understands that the child cannot be born on his own. But more often, some narrowing of the pelvis is diagnosed, in which it is still possible to give birth to a small child on your own.

2. High degree of myopia (nearsightedness). The question of the operation is decided after consultation with an ophthalmologist. It often happens that a woman is still allowed into natural childbirth, but with the use of epidural anesthesia and they try to shorten the period of attempts as much as possible.

3. The threat of divergence of the scar on the uterus. At what time is a planned caesarean section done and how it goes depends on the viability of the scar on the uterus, that is, its thickness throughout. If there is a suspicion of its failure, the operation can be postponed to an earlier date, 37-38 weeks.

4. Breech presentation of the fetus or other, not head. A planned fetus is done if a woman is carrying a boy. Fortunately, modern ultrasound machines make it possible to almost accurately determine the sex of a child. Or if the baby weighs more than 3.5 kg and the woman is nulliparous. Girls can be allowed to give birth on their own to multiparous women if the weight of the child is less than 4 kg, and in the maternity hospital there is the possibility of an emergency operation. The transverse position of the fetus is an absolute indication for surgery.

5. Symphysite. A planned caesarean section at 39 weeks or even earlier is done with this pathology. The term depends on the degree of divergence of the pelvic bones of a pregnant woman and her well-being. With pronounced symphysitis, independent childbirth is contraindicated. An accurate diagnosis is made on the basis of ultrasound data.

6. Non-occurrence of labor activity, despite ongoing "stimulating" therapy. Sometimes it happens that the fetus already has signs of “overripeness”, there is reason to believe that it has hypoxia, there is little amniotic fluid, but childbirth does not begin in any way. Then, especially if a woman is over 28 years old and is giving birth for the first time, doctors may recommend that the expectant mother be relieved of the burden by surgery. What week is a planned caesarean section done in this case? Usually, adverse signs of a post-term pregnancy appear at 41-42 weeks. That is, the timing for the operation is individual.

7. Some cardiovascular diseases, heart defects. If a woman is generally well pregnant, the maternity hospital may suggest that she be hospitalized immediately at the onset of labor, or when, as a result of examining the cervix, it becomes clear that an independent birth is about to begin. At what time do the planned - you ask? As close as possible to the onset of natural childbirth. Indeed, otherwise, the likelihood of difficulties with adapting to the external environment in the fetus remains high. Sometimes even full-term babies who were born by caesarean section, but prematurely, have problems with spontaneous breathing. That is, often a planned second cesarean is done for a period of about 40 weeks, when the amniotic fluid leaves, or the woman begins to feel cramping pains.

Less often, the reasons for the operation are varicose veins in the vaginal area, pronounced hemorrhoids (there is a possibility of thrombosis of the nodes).