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This incision also comes with possible risks and complications when the incision is made and during repair, including blood loss (possibly leading to anemia), wound infection, fertility problems, premature labor, postoperative pain, and many others. [3] In addition, a rare form of ectopic pregnancy known as scar ectopic pregnancy can occur ...
Hypertrophic (very thick or unsightly) scars are best excised because it gives a better cosmetic result and is associated with improved wound healing. On the other hand, keloid scars should have their margins left without any incision because of risk of tissue reaction in the subsequent scar. [10]
[1] [3] [4] The threshold for this is passed when the uterus is so large that the fundus may be palpated at the level of the woman's umbilicus; for a singleton pregnancy, this occurs at around 20 weeks of gestational age [3] [4] (but may be earlier in multiple pregnancy). Although hysterotomy is crucial for resuscitation of the mother in such ...
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.
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
An old cesarean scar may undergo dehiscence; with further labor the woman may experience abdominal pain and vaginal bleeding, though these signs are difficult to distinguish from normal labor. Often a deterioration of the fetal heart rate is a leading sign, but the cardinal sign of uterine rupture is loss of fetal station on manual vaginal exam.
If placenta previa is present at the time of delivery, vaginal delivery is contraindicated because the placenta is blocking the fetus's passageway to the vaginal canal. Herpes simplex virus with active genital lesions or prodromal symptoms is a contraindication for vaginal delivery so as to avoid mother-fetal transfer of HSV lesions.
Kerr published the results in 1920, proposing that this method would cause less damage to the vascularized areas of uterus than the classical operation. He claimed that it was better than the longitudinal uterine incision in terms of chances for scar rupture and injury to vessels. [9]