『Re-Release: C-Section Delivery Done Right: Dr. Abdelhak's Cesarean Birth Guide. Episode #50』のカバーアート

Re-Release: C-Section Delivery Done Right: Dr. Abdelhak's Cesarean Birth Guide. Episode #50

Re-Release: C-Section Delivery Done Right: Dr. Abdelhak's Cesarean Birth Guide. Episode #50

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 When a c-section birth is done with care and precision it can make all the difference in the healing and recovery for the mother. Operating the right way will also enable a woman to continue to have more pregnancies in a safe and secure way. In this episode, Dr. Yaakov Abdelhak, a high risk perinatologist MFM specialist, lays out his method for operating in a c-section and includes what can be discussed ahead of time from a woman to her provider. What an opportunity as he reveals his unique method for conducting C sections step by step in this episode of The True Birth Podcast. He explains the best ways to perform the surgery to minimize the risking scarring, post-operative pain and complications. Planning C-Section [3:45] No one thinks they're going to have a C-section until the time comes to have a C-section. Because the heart rate in labor may stop progressing, you won't have time to develop a C-Section when the time comes. It is something that needs planning, like a birth plan. Doctors, on the other hand, dislike being taught how to operate. However, they will tell you things that are entirely feasible and reasonable. Plan C [4:43] When a patient is on the operating table, the personnel in the room, such as the surgeon and nurses, must take a timeout to ensure that everyone is on the same page and help the patient clarify the surgical case. [5:48] Before Dr. Abdelhak makes an incision, he uses a marker and draws a line about two inches above the pubic bone. Some people have a natural line that is sometimes faded or darker in pregnancy because of more melanin deposits. Why Dr. Abdelhak has a marker [10:31] If you put a patient back together just a half-centimeter off on the skin, which has the most nerve ending and they're going to feel it, it's important to pay attention and make sure you get them back exactly the way they came apart. Performing C-Section [11:51] Once you open up the skin, the next step is to now get through the subcutaneous fat. Most of the time, you take the electric cautery, and you burn down to the fascia so that you can see the fascia. The fascia is the membranous connective tissue that holds everything together. It's the linings of the muscles that come together in the midline. It's a white, very thick sheet that's holding your abdominal sheet. Cut down to the level of the fascia only in the midline with the electric cautery. Then bluntly separate the rest on the right and left with your fingers because what you're doing is you're pushing the blood vessels laterally instead of cutting them. [15:06] When you open the fascia, you have to do it in the same direction as you're doing the skin. Underneath the fascia is a muscle, and now you have to get through the muscle. Doctors learned that it is terrible to cut the abdominal muscles because it's better to pull them to the side. After all, there's a natural kind of separation between the two. [15:45] Pull the muscles to the side, stretching before you pull both sides. You have to separate that overlying fascial sheet from the muscles to the side. Then you enter the perineum that is holding all your abdominal content. Now you have exposure to the uterus. At this point, you are making sure that you have enough exposure. [17:12] Making a small incision on the skin is very important to have a good recovery. If you have a repeat C-section, you have to go more prominent because you need more exposure. If somebody has a repeat C-section, they might think about opening a larger incision. You have to make no incision on the uterus. Before you go inside the uterus, look at the bottom to make sure the uterus is not tilted to the right or left. It's essential to know that if it's tilted, you can end up cutting some blood vessels. The Bladder Flap [19:05] The bladder runs directly over the uterus, and the perineum joins the bladder to the uterus and becomes the uterus's skin. There is a stage in between where it exits the bladder and forms the uterine skin. You can see on the uterus a potential space. You lift that space, you make a minor incision, you lift it, and when you push the bladder up and away from the uterus, you have more exposure to the lower uterine segment. Opening the Uterus [20:36] When you open up the uterus, you have to be careful not to cut the baby. It would help if you had a "butterfly touch" whenever you are cutting through the uterus. You can use the suction, then use your finger, and you rub it. It will cause the cut to open up more rather than performing another incision. [24:03] The thick borders are critical because the uterine wall collected at the lateral edges is protective from extending the incision. So when you pull the baby's head out, if you have a sharp edge there, it's straightforward for the pressure or your hand and the baby's head to cause that sharp edge to elongate. When it elongates, it goes where it wants, ...

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