Lower Segment Cesarean Section (LSCS)

Indications

A lower segment cesarean section may be performed for various medical reasons when vaginal delivery is not possible or not recommended. Some common indications for LSCS include:

• Previous cesarean section with a low transverse uterine incision (elective repeat cesarean section)
• Fetal distress or abnormalities detected during labor
• Breech presentation or other abnormal fetal positions
• Placenta previa (placenta covering the cervix)
• Placental abruption (detachment of the placenta from the uterus)
• Maternal medical conditions that pose risks to vaginal delivery

Preparation

Before the cesarean section, the pregnant individual will receive anesthesia (usually regional anesthesia such as epidural or spinal anesthesia) to numb the lower half of the body while remaining awake. An IV line will be placed to administer fluids and medications, and vital signs will be monitored throughout the procedure.

Surgical Procedure

1. Sterilization and Draping: The surgical team will sterilize and drape the abdomen to maintain a sterile field.
2. Incision: An incision is made horizontally (transversely) across the lower abdomen, just above the pubic hairline, typically about 1-2 inches above the pubic bone.
3. Exposure of the Uterus: The incision is extended through the skin, subcutaneous tissue, and into the abdominal cavity, exposing the uterus.
4. Uterine Incision: A separate incision is made in the lower uterine segment, avoiding the upper part of the uterus, where the placenta is typically located during pregnancy. This minimizes the risk of bleeding and complications during the procedure and future pregnancies.
5. Delivery of the Baby: The baby is carefully delivered through the uterine incision, and the umbilical cord is clamped and cut.
6. Placenta Removal: The placenta is then removed from the uterus.
7. Closure of the Uterine Incision: The uterine incision is closed in layers with sutures to ensure proper healing and minimize the risk of uterine rupture in future pregnancies.
8. Closure of the Abdominal Incision: The abdominal incision is closed with sutures or staples, and a sterile dressing is applied.

Postoperative Care

After the cesarean section, the pregnant individual will be monitored closely in the recovery area for any signs of complications, such as excessive bleeding, infection, or anesthesia-related side effects. Pain medication may be provided to manage postoperative discomfort, and breastfeeding and bonding with the baby can usually begin soon after the procedure.

Recovery

Recovery from a lower segment cesarean section typically takes several weeks. It's important for the individual to follow their healthcare provider's instructions for postoperative care, including wound care, pain management, activity restrictions, and follow-up appointments.

Benefits and Risks

• Benefits: LSCS is a safe and effective method for delivering babies when vaginal delivery is not feasible or advisable. It reduces the risks associated with prolonged labor or complicated vaginal deliveries.
• Risks: As with any surgical procedure, there are risks associated with LSCS, including infection, bleeding, blood clots, and reactions to anesthesia. However, advances in medical technology and surgical techniques have significantly improved outcomes and reduced complications associated with cesarean section deliveries.

Overall, a lower segment cesarean section is a commonly performed and generally safe procedure that can be crucial for the health and safety of both the mother and the baby when complications arise that make vaginal delivery too risky.