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
1 comments:
I had my first seizure. I was in high school and didn't want anyone to know that I had epilepsy. I had seizures on two occasions. I was so ashamed and didn't want people to think that something was wrong with me. I finally got to the point where I told people that I had epilepsy. I came to the place that I realized that I had to own my epilepsy or it would control me. Epilepsy hadn't really affected my life until about 9 years ago after my first child was born... I am a wife and mother of two beautiful children. I have lived with epilepsy for 20 years Yet, my life has been dramatically impacted by epilepsy. I had search for cure online without no hope. I met a Man called Dr Adams, i contact him I made an order of his medicine and I do not experience seizure anymore i was cured form it. So if you are in the same situation as mine contact him on this email [ adamslord85@gmail.com ]
He cure listed diseases
.CANCER
.HIV
.ALS
.HEPATITIS A AND B
.DIABETIC.
.HERPES
Post a Comment