Caesarean section in women with preeclampsia

Preeclampsia is considered one of the common diseases in pregnant women, negatively affecting the health of both the pregnant mother and the fetus, if more severe can lead to death in the mother. . Therefore, cesarean section is considered as a necessary treatment option in some cases of preeclampsia in high-risk pregnancy to protect the mother's life.

Preeclampsia is one of the common obstetric diseases in pregnant women with an average incidence of 2% - 8%. The causes of preeclampsia have not been fully studied to date, however the occurrence of preeclampsia is associated with a number of risk factors as follows:
First time pregnancy Older pregnant mother over 35 or younger than 20 years old The mother has a history of chronic hypertension The pregnant mother has some kidney-related disease or connective tissue disease The mother has been pregnant many times In the family there is a family member with preeclampsia eclampsia, eclampsia People with a predisposition to obesity

Tobacco users People with some diseases related to blood vessels People with diabetes . Clinically, pre-eclampsia includes many diseases with very different diagnostic symptoms, including:
Mild preeclampsia: systolic blood pressure greater than 140 mmHg or diastolic blood pressure exceeding 90 mmHg with signs proteinuria greater than 300mg/24h or this proteinuria higher than the previous proteinuria. Mild pre-eclampsia can occur at any time during pregnancy, or sometimes outside of pregnancy, with the following rates: 25% before birth, 50% during delivery, and 25% after birth. Some other manifestations of mild pre-eclampsia are increased tendon reflexes, headache, dizziness, vision loss, dizziness, oliguria, epigastric abdominal pain... Subclinical signs also contribute to the diagnosis of mild pre-eclampsia, which is an increase in SGOT, SGPT, uric acid and bilirubin, in contrast, the platelet count as well as the total serum albumin have signs of decreased compared to the initial value. .
Severe preeclampsia: Systolic blood pressure greater than 160 mmHg or diastolic blood pressure greater than 110 mmHg measured at least 2 times, approximately 6 hours apart. In addition, some organs will also be damaged when a patient has severe pre-eclampsia such as:

Kidney damage: typically acute renal failure if the proteinuria is greater than 3g/24h or sudden oliguria accompanied by a rapid rise in serum creatinine. Liver damage: impaired liver function, subcapsular hematoma... Hemodynamic pulmonary edema Cardiovascular system damage: occurrence of acute hypertension, heart failure, cardiac arrest... Nervous system damage Menorrhagia: patients will have headaches, blurred vision, convulsions, cerebral hemorrhage... Vascular damage: platelet count drops below 100000/mm3 and intravascular coagulation plaques appear. HELLP syndrome Fetal failure: polyhydramnios or oligohydramnios occurs, fetal heart rate is not measured, placental abruption, stillbirth, intrauterine growth retardation.

For dangerous diseases such as pre-eclampsia, eclampsia and some other obstetric diseases, cesarean section is a commonly indicated surgical method, with the aim of delivering the fetus and its appendages from uterine cavity to the outside environment through the opening of the abdomen and the opening of the uterus.

The cesarean section is performed according to the following steps:
Prepare the instruments and prepare the patient, and explain to the patient and family about the cesarean section method. Urinary catheterization for the patient Disinfect the abdominal wall and perform a sterile dressing after injecting pain medication to the patient. Open the abdomen at the midline of the navel or the horizontal line above the pubic part, then expose the area to be operated on and proceed to insert gauze and reach the valve. Open the peritoneum below the mother's uterus. Transverse incision of the lower uterine muscle to the amniotic membrane Open the lower part of the uterus in the middle so that it does not touch the fetus below, widen the incision to both sides to make surgery easily. It should be noted that the hysterotomy must be parallel to the opening of the lower abdominal peritoneum and the lower transverse incision should be between 8cm and 10cm in length. Carry out cesarean section: Take the fetus first in the case of the first position, or remove the fetus's legs and buttocks in the case of other fetuses in the first position. Then use a gauze pad to wipe the baby's mouth. Next, clamp and cut the umbilical cord with forceps and inject 10 units of Oxytocin slowly intravenously through the infusion line.

Get the placenta by pulling on the umbilical cord and pressing on the part of the abdomen that corresponds to the bottom of the uterus. Carry out cleaning of the uterine cavity. Check the uterus, it is possible to dilate the cervix to make it easier to check, if the large blood vessels are still flowing, then clamp the blood vessels for the mother. The uterine incision is sutured with standard sutures, either loose or unlocked or locked so that all of the uterine muscle is removed, with single or double sutures if necessary. Peritoneal suture to limit infection after cesarean section. Clean the operated abdominal cavity, examine the uterus for fetal appendages and surgical instruments, and examine the surrounding organs. Placement of abdominal drainage in some cases Close the abdominal wall in anatomical layers. Incisional drainage can be placed. Blood can be taken for monitoring and vaginal cleaning for pregnant women.

Cesarean section is considered a necessary indication if during pregnancy, the woman suffers from certain diseases such as pre-eclampsia, eclampsia and some other health problems. However, this is an invasive technique and carries a risk of some complications, so it should be performed by doctors and medical teams with high expertise in this field.
To protect the health of pregnant women and their babies during pregnancy, Vinmec International General Hospital provides a package of maternity services as a solution to help pregnant women feel secure because of the companionship of the medical team. doctor throughout pregnancy. When choosing Maternity Package, pregnant women can:
The pregnancy process is monitored by a team of highly qualified doctors Regular check-ups, early detection of abnormalities The package pregnancy helps to facilitate convenient for the birthing process Newborns get comprehensive care