Thursday, February 24, 2011

Consent for elective caeserian section


1. Introduction

2. Explain indication

- breech presentation

-previous scar

-placenta previa major

-macrosomic baby

-unstable lie

-fibroid / cyst obstructing the lower segment

3. Explain on procedure

- we will give admission form to admit to ward one day prior to operation

- ELSCS at 38 weeks

-fasting start at 12MN

-blood taking for FBC and GXM 2 pints pack cells

-also take consent for blood transfusion and hysterectomy in case anything happened

-CBD will be inserted in the morning before operation

-prophylaxis antibiotic will be given

- operation done by epidural/ CSE – anaest will review before operation

-duration 30-45 minutes

- lower abdomen will be cut for 10cm, baby out, placenta out, sutured

4. Explain complication

Early

- anaesthetic complication : nausea, vomiting, headache

-bleeding / PPH

- injury to bladder/ colon

-infection

Late

-decrease family size, limit to 3 lscs only

- adhesion

-next pregnancy LSCS

5. Postpartum

- 3 days monitoring in the ward for any bleeding

-give prophylaxis s/c heparin 5000iu thromboprophylaxis

-Wound inspection at day2

-monitor urine output, CBD will be romeved if patient can ambulate well

6. Advice patient on contraception

- need to have good spacing 2 years

- use contraceptive device that has good pearl index

-ensure patient compliance

-TCA 6 weeks at family planning clinic

7. Ask for any enquiries


sources: teaching with dr nasir

hanisah A115275

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