Modification of the SCA Technique
Journal Title: Interventions in Gynaecology and Women’s Healthcare - Year 2018, Vol 2, Issue 1
Abstract
As you would be appreciate, the rate of cesarean sections increased from 4.5% to 31.8% between the years of 1970 and 2007. Although the maternal morbidity and mortality have seriously declined within years due to the implementation of cesarean section, reduction of the complication rates has still considerableimportance, and the revision of the technique and modifications will make contributions to this issue, which involves numerous factors. Therefore, I wanted to describe the lower segment transverse cesarean incision technique, which I have been using with quite a low complication rate for more than ten years. Some of the key points in the currently known and implemented transverse cesarean incision technique are as follows: After entering the abdomen through the suprapubic transverse incision, some surgeons put gauzes into the abdominal cavity for absorption of the blood and the amniotic fluid. Then, the loose peritoneal fold on the upper border of the bladder and the lower anterior uterine segment- bladder flap-is grasped by a haemostatic forceps in the midline. It is cut transversally either with a scalpel or scissors. The scissors are placed between the vesicouterine peritoneum and the myometrium of the lower uterine segment. The scissors are advanced from the midline to the lateral sides. Then, while leaving a space between the scissor tips, the scissors are partially withdrawn. Then, this serosal strip, 2-cm in length, is cut and separated. When the lateral sides are approached, the scissor tips are directed towards the fetal head. The lower flap of the peritoneum is elevated and gently dissected from the underlying myometrium by using blunt and sharp dissection. The depth should not exceed 5 cm, in general. There is a probability of entering the vagina at this point, which is deepened in pregnant women who have suffered from labor pain. The uterus is opened throughout the lower uterine segment at approximately 1cm below the upper border of the peritoneal fold. In pregnant women with advanced or complete cervical opening, making the uterine incision from a relatively higher site is important regarding the reduction of the widening probability of the incision laterally towards the uterine arteries together with the unintentional entrance to the vagina. This can be performed by using the guidance of the vesicouterine fold.
Authors and Affiliations
Nadi Keskin
Keywords
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- EP ID EP573191
- DOI 10.32474/IGWHC.2018.02.000128
- Views 89
- Downloads 0
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