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Caesarean Section CS

*Indications for cesarean section:

.Transverse lie

.Mento-posterior position (Face presentation “mento-anterior” is not indication fo CS)

.Fetal distress in the first stage

.Prolapsed pulsating cord

.Carcinoma of the cervix

.Severe adhesions in the lower uterine segment

.Large cervical fibroid

.Posterior placenta previa grade II

.Previous Caesarian section

.Mal presentation

*The period of time from the end of delivery until the reproductive organs have returned to normal is called (Puerperium)

*Postpartum hemorrhage is diagnosed when blood loss exceeds 500cc

*In primary postpartum hemorrhage the most common cause is Atonic uterus

* The most common cause of secondary postpartum hemorrhage is Retained parts of placenta superimposed by uterine infection

*Postpartum hemorrhage:

.More common in twin pregnancy than single pregnancy

.Less common in primigravida than multigravida

.It may be caused by bleeding from non-placental site

.The prevention is by active management of the third stage of labor

*Uterine atony might be caused by:

.Prolonged labor

.Multiple pregnancy

.Polyhydramnios

.Uterine fibroids

*The commonest cause of maternal pyrexia in puerperium is Endometritis

*The most common cause of post partum mastitis is Staphylococcus aureus

*The most common bacteria causing puerperal infection is Anaerobic streptococcus

*The helpful investigation to diagnose pulmonary embolism is Lung spiral CT

*The most common site of puerperal infection is The upper genital tract (endometrium)

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