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Although fetal delivery through caesarean section is a very common surgery done in the world, it comes with several risks including bleeding, infection, thromboembolism, and soft-tissue injury. During a caesarean section, a hysterotomy is utilized to make an incision in the uterus and remove the fetus. [ 8 ]
Cardiac arrest occurs during pregnancy; Patient is not revived by basic and advanced life support (e.g. CPR and defibrillation) techniques; The uterus is large enough to cause aortocaval compression; The third condition is met when palpation finds the top of the uterus level with the navel.
A hysterotomy is performed on the pregnant woman, and once the uterus is open and the fetus is exposed, the fetal surgery begins. Typically, this surgery consists of an interim procedure intended to allow the fetus to remain in utero until it has matured enough to survive delivery and neonatal surgical procedures.
The risk of hemorrhage is greater if the fetus has a defect that affects its platelets. A transfusion of donor platelets is usually done in such cases to reduce the risk of bleeding. If the bleeding is severe, immediate delivery is an option as long as the fetus is old enough to survive, or fetal blood volume restoration may be considered. [9]
Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening or opening) of the cervix and surgical removal of sections and/or layers of the lining of the uterus and or contents of the uterus such as an unwanted fetus (early abortion before 13 weeks), remains of a non-viable fetus, retained placenta after birth or abortion as well as any abnormal tissue which may be in the ...
In the developed world about 1% to 2% develop uterine infections following vaginal delivery. [1] This increases to 5% to 13% among those who have more difficult deliveries and 50% with C-sections before the use of preventive antibiotics. [1] In 2015, these infections resulted in 17,900 deaths down from 34,000 deaths in 1990.
The risks of intact D&E are similar to the risks of non-intact D&E and include postoperative infection, hemorrhage, or uterine injury. Overall, the complication rate is low, with rates of serious complications (those requiring blood transfusion, surgery, or hospital treatment) ranging from 0 per 1,000 cases to 2.94 per 1,000 cases.
Dilation and evacuation can be offered for the management of second trimester miscarriage if skilled providers are available. [6] Some women choose D&E over labor induction for a second trimester loss because it can be a scheduled surgical procedure, offering predictability over labor induction, or because they find it emotionally easier than undergoing labor and delivery.