Find out about surgical removal of the uterus after cesarean section

The article was professionally consulted with Specialist Doctor I Le Thi Phuong - Obstetrician and Gynecologist, Vinmec Ha Long International General Hospital.

The hysterectomy is a routine procedure applied at Vinmec Hai Phong hospital after cesarean section. The method is applicable to all women after cesarean section.

Restoration of the uterus for pregnant women after giving birth Minimize the adhesion of the uterus to the abdominal wall and adjacent organs. Limit the risk of uterine rupture for the next pregnancy. However, after surgery, a small amount of fluid will remain at the incision site. If not cared for carefully, it can lead to an infection of the surgical site.

Step 1: Perform cesarean section
1: Laparotomy
2: Open the lower peritoneal peritoneum
3: Transverse incision of the lower uterine muscle to the amniotic membrane
4. Take pregnancy and placenta
Step 2: Repair the incision and restore suture
Sewing to restore the uterine muscle layer with the index number 1. Can be with a separate stitch or a suture with or without a buckle. The suture takes the entire thickness of the myometrium. The endometrial layer should not be sutured. Usually one layer stitch is enough. If necessary, suture a second layer of suture to stop bleeding and cover the first layer. Lower uterine peritoneum is mandatory when there is a risk of infection. Step 3: Post-operative care
Wipe the abdomen, check the uterus, appendages and surrounding organs, count enough gauze Close the abdominal wall layer by layer. Take blood and wipe the vagina

Patients should be re-examined immediately when there are symptoms of pain at the incision, fever and anemia. If not promptly treated, the following complications may occur:
Infection: Surgical site infection, amniotic infection causing peritonitis are common complications that can lead to hysterectomy in the postoperative period. . Intestinal paralysis. Open the incision, hernia of the abdominal wall. Venous embolism, thrombosis. Intestinal adhesions, intestinal obstruction. Obstruction of the fallopian tubes causes secondary infertility. Endometrial optimism . Scars on the body of the uterus can crack in later pregnancies.

Diet: Pregnant women should not eat any food within the first 6 hours after surgery. Principles of eating after surgery: Pregnant women will eat from liquid to solid, eat rice when deflated.
The first day after surgery: Pregnant women should only drink filtered water, sugar water, eat diluted porridge. After farting: Pregnant women eat and drink as usual, increase nutritious foods such as meat, fish, eggs, milk..., avoid spices with stimulants such as chili, coffee, tea will cause affect lactation. General principles of eating: Drink enough water (about 2 liters of water), eat well cooked, increase green vegetables, fruits to avoid constipation. Mode of movement and rest:
The first day after surgery: The mother can move her limbs, turn gently at the bed. In the following days: Depending on your health condition, you can step out of bed and practice walking again to help your body's normal functions recover faster, reducing the risk of complications after surgery. (separation, embolism...). However, for women who have had a very difficult labor before a cesarean section or have lost a lot of blood at birth, they need more rest.
Incision care: After 3-5 days, the incision will heal. Depending on the type of suture, the mother may or may not need to cut the sutures after wound recovery:
If the incision is sewn according to the criteria: No need to cut the suture after surgery. If the incision is sewn with undigested sutures: Usually, the thread will be cut from the 5th to 7th day after surgery, depending on the doctor's instructions. After the suture is removed, the mother can wipe her body or take a quick bath with warm water, then dry the whole body and the incision. Pay attention not to cover the incision or apply antiseptic solutions to the incision if not indicated.
Breastfeeding: After giving birth by cesarean section under anesthesia, women can breastfeed after 30 minutes to 1 hour. For women under general anesthesia, the time is longer, usually after 6 hours.
Hysterectomy technique after cesarean section at the Department of Obstetrics and Gynecology - Vinmec Hospital achieved high sterility, the rate of postoperative infection due to surgical technique and equipment was low. In addition, the technique is performed by experienced obstetricians.