Catastrophic lower uterine segment injuries during caesarean, The impacted fetus
Christos Tsitlakidis
Pinderfields Hospital, UK
: Androl Gynecol: Curr Res
Abstract
Introduction: The integrity of the lower segment is always a nice sightseeing for the surgeon at caesareans. Injuries to the low part of uterus can be caused by a traffic accident, prolonged labour, repeated caesareans, operational vaginal delivery and more. When severe injuries occur, such as scar dehiscence, uterine rupture, broad ligament tears and cervical lacerations, bleeding can be catastrophic and will not respond to oxytocics and compression suturing techniques. What’s more, the impacted foetal head threatens to jeopardise the whole procedure. It may require general anaesthesia and imposes threat to foetus. Medico legal implications can arise for staff involved, either been unsuccessful or caused damages to foetal skull and brain haemorrhage.
Purpose: To show methods to prevent and deal with injuries, to exhibit available products to disengage impacted head, to stage injuries based on the level they appear.
Methods: Giving the facts, alerting surgeons for potential injuries. Foreseeing major haemorrhage with all caesareans using surgical expertise and improved techniques, to prevent and deal with emergencies, to show limitations from available products. Staging and recording injuries so to revise in audits.
Conclusion: Reviewing the lower segment injuries as the most difficult to deal emergency during caesareans, especially in conjunction with impacted foetal head, will change our approach to the procedure. Recording the injuries will help to audit and deal well with them when they occur.
Biography
Christos Tsitlakidis has graduated from Hellenic Aristotle University School of Medicine. He is a Consultant Obstetrician and Gynaecologist in Pinderfields Hospital, MidYorkshire NHS Trust, United Kingdom. He has published more than 6 papers in reputed journals in UK and abroad and has been member of the RCOG.
E-mail: ctsitlakidis@yahoo.co.uk
