1. Vertical
Incision
Incision
2. Transverse
Incision
Incision
1. Vertical
incision
incision
This is called the classical caesarean section, it is often described as
the upper segment caesarean section (USCS) In this type of incision a
para-median incision is made through the abdominal wall into the uterus. The
incision could be sub-umbilical or could extend above the umbilicus. It is less
vascular and gives good exposure of both the abdominal and pelvic organs. It is
associated with less blood loss and performed in cases of fetal distress, when
rapid both is indicated.
the upper segment caesarean section (USCS) In this type of incision a
para-median incision is made through the abdominal wall into the uterus. The
incision could be sub-umbilical or could extend above the umbilicus. It is less
vascular and gives good exposure of both the abdominal and pelvic organs. It is
associated with less blood loss and performed in cases of fetal distress, when
rapid both is indicated.
The wound in this type of incision heals poorly and leaves a weak scar
on the uterus and same the place of the placenta is usually situated in the
upper uterine segment, the scar may further weaken if the placenta is situated
in the area of the previous scar. This accounts for rupture during subsequent
labour.
on the uterus and same the place of the placenta is usually situated in the
upper uterine segment, the scar may further weaken if the placenta is situated
in the area of the previous scar. This accounts for rupture during subsequent
labour.
The advantage is that the danger of damage to the urinary bladder is
reduced.
reduced.
2. Transverse
incision
incision
This is also known as the low segment caesarean section (LSCS). It is
the incision of choice. The incision is made across the abdominal muscles and
uterine muscles.
the incision of choice. The incision is made across the abdominal muscles and
uterine muscles.
The wound of this type of incision heals faster and scar heals well and
does not give rise to rupture in subsequent labour.
does not give rise to rupture in subsequent labour.
The placenta is not likely to be situated in the lower uterine segment
except in about 3% of women who have had placenta praevia. In addition the scar
of the lower uterine segment is covered by the peritoneum of the utero-vesical
pouch and this protects it from being infected.
except in about 3% of women who have had placenta praevia. In addition the scar
of the lower uterine segment is covered by the peritoneum of the utero-vesical
pouch and this protects it from being infected.
A woman who has had a lower segment section for reasons other than
cephalopelvic disproportion may be allowed to attempt vaginal delivery in
subsequent pregnancy and delivery.
cephalopelvic disproportion may be allowed to attempt vaginal delivery in
subsequent pregnancy and delivery.
There are 3 types of transverse incision.
A. Bikini
– line incision
– line incision
It involves dissection of the anterior rectus muscle sheath and extended
into the external and oblique muscles. It is widely used because of its
excellent cosmetic result. There is early ambulation and low incidence of wound
disruption dehiscence and herniation.
into the external and oblique muscles. It is widely used because of its
excellent cosmetic result. There is early ambulation and low incidence of wound
disruption dehiscence and herniation.
B. Maryland
incision
incision
This type of incision involves cutting the rectus muscle transversely
and ligating the interior epigastric artery. It is usually provide better
assess than the bikini-line incision.
and ligating the interior epigastric artery. It is usually provide better
assess than the bikini-line incision.
C. Cohen’s
incision
incision
It is a straight transverse incision place slightly higher than the
bikini-line incision usually 3cm higher.
bikini-line incision usually 3cm higher.