Cesarean section
Anesthesia type
Airway
Lines and access
Monitors
Primary anesthetic considerations
Preoperative

Full stomach precautions
as

Intraoperative
Postoperative
Article quality
Editor rating
Comprehensive
User likes
2

A Cesarean section, also known as C-section, is a surgical procedure where the baby is delivered through an incision in the uterus. C-sections are typically performed when a vaginal delivery would put the mother or baby at risk. As of 2017, about 32% of deliveries in the United States were performed via C-section[1].

Preoperative management

Patient evaluation

System Considerations
Neurologic
Cardiovascular
  • Pregnant patients typically have decreased systemic vascular resistance, decreased diastolic pressure, decreased MAP, increased HR, and increased CO.
  • Left uterine tilt to minimize aortocaval compression
Respiratory
  • Pregnant patients typically have compensated respiratory alkalosis, increased minute ventilation, decreased FRC, and increased oxygen consumption.
  • Decreased FRC results in rapid desaturation if ventilation is compromised.
  • Atelectasis can occur secondary to an elevated diaphragm, thereby causing V/Q mismatch and decreased PaO2.
  • Increased MV and decreased FRC increase uptake of inhalational agents.
  • Mucosal capillary engorgement in upper airway may necessitate smaller endotracheal tube.
Gastrointestinal
  • Increased gastric pressure
Hematologic
Renal
Endocrine
Other

Labs and studies

Operating room setup

Patient preparation and premedication

Regional and neuraxial techniques

Intraoperative management

Monitoring and access

Induction and airway management

  • Avoid nasal airways due to potential for mucosal capillary engorgement in upper airway

Positioning

  • Left lateral tilt (15o) to avoid aortocaval compression and supine hypotension.

Maintenance and surgical considerations

  • Immediately post-partum, ~600-800 mL of blood will enter the central circulation (placental autotransfusion), which will increase cardiac output

Emergence

Postoperative management

Disposition

Pain management

Potential complications

Procedure variants

Variant 1 Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References

  1. "Births: Provisional Data for 2017" (PDF). CDC. May 2018. Retrieved 18 May 2018.