Cesarean Delivery, Emergency: Risks/Benefits


  1. Risks:
    • infection;
    • injury to maternal tissues and internal organs;
    • injury to fetus at delivery;
    • need for application of vacuum or forceps to expedite delivery in cesarean section;
    • 10% of patients undergoing emergent CD require transfusion due to severe maternal hemorrhage;
    • risks of transfusion reactions and acquired infections from blood products;
    • risk of hysterectomy for intractable uterine hemorrhage;
    • risk from administration of aneathesia;
  2. Benefits
    • decrease in short- and long-term morbidity;
    • in cases of severe maternal hemorrhage, maternal morbidity and mortality are decreased.
  3. Complications
    1. Infection:
      • wound infection;
      • wound dehiscence;
      • wound seroma;
      • wound hematoma;
      • uterine infection,endometritis;
      • pneumonia;
      • UTI;
      • pyelonephritis;
      • mastitis;
    2. Thromboembolic events:
      • DVT/PE (deep venous thrombosis/ pulmonary embolism);
      • septic pelvic thrombophlebitis;
    3. Hemorrhage/Bleeding:
      • Fatigue;
      • Orthostatic hypotension with syncope;
      • Iron deficiency;
      • Need for transfusion;
      • Need for hysterectomy;
      • Maternal mortality;
    4. Injury to internal organs
      • bladder injury requiring prolonged catheterization;
      • ureteral injury;
      • bowel injury with or without colostomy;
      • bowel resection due to extensive injury;
      • excision of fallopian tube and/or ovary for the control of severe hemorrhage;
    5. Risk of anesthesia:
      • aspiration of gastric contents;
      • high spinal with need for endotracheal intubation;
      • inability to ventilate with maternal hypoxia and brain injury;
      • maternal mortality due to hypoxia or cardiovascular collapse.

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