Cesarean section

Anatomy Perioperative management Technique Complications Evidence Total Video

Content

Positioning
Marking incision line
Opening of the abdominal wall
Opening Peritoneum
Preparation of the urinary bladder
Uterotomy
Child delivery/extraction
Retrieval of the placenta and fetal membranes
Exteriorization of the uterus
Corpus curettage and dilation of the cervix uteri
Closure of uterotomy
Inspection Abdomen
Closure of the parietal peritoneum
Subfascial Hemostasis
Fascial closure
Local anesthesia Subcutaneous hemostasis
Skin suture

Authors

Dr. med. Karol Kubiak

Oberarzt, Klinik für Gynäkologie und Geburtshilfe, Gynäkologisches Krebszentrum, St. Franziskus Hospital, Münster

Leitender Arzt, Klinik für Gynäkologie, Maria-Josef-Hospital, Greven

Date

date of publication: 11.03.2025

Positioning
- The patient is positioned in the supine position
- Legs slightly bent:
  The legs were slightly bent and the knees supported with a soft pad to ensure a comfortable position and avoid muscle tension.
- Arms positioned:
  Both arms are extended and padded, which is important for the administration of intravenous medications and fluids.
- Head and neck support:
  The patient's head was placed on a soft, ergonomic pillow to support the natural curvature of the cervical spine.
- Thermoregulation:
  To prevent hypothermia, the patient was covered with a warmed cloth or thermal blanket, while the surgical field remained sterilely exposed.
- Urinary catheter:
  Before the start of the surgery, a transurethral urinary catheter was inserted to empty the bladder and minimize the risk of injury during the uterotomy.
Marking incision line

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After positioning and disinfecting the patient, the planned incision line in the suprapubic region was marked. This typically involved the Pfannenstiel incision, a transverse skin incision approximately 2–3 cm above the symphysis.
The marking is done using a sterile skin marker. With the help of a ruler or scale, the length of the planned incision (approximately 10–15 cm, depending on anatomical conditions) was measured and marked.