hegar dilatorsThe first was an elective lower segment caesarean section (LSCS) done at 38 weeks gestation for a patient with gestational diabetes mellitus. The indication was a previous LCSC done for the patient’s [now] 2-year-old child. A previous caesarean section is not an absolute contraindication to normal vaginal delivery, as there is this entity known as Vaginal Birth After Caesarean Section (VBAC). The consultant made a transverse incision roughly above the bladder, slowly dissected through the fat layer, rectus sheathe and uterine wall. A gush of liquor followed the rupture of the membranes. She then proceeded to deliver the child in vertex presentation while the medical officer pushed down on the uterus from above. The baby looked slightly bluish at the start and was covered in vernix caseosa.
The neonatologist took care of the neonate and eventually it began to cry, though not as strongly as a normal vaginal delivery full-term neonate. The rest of the surgery involved closing up the uterus in two layers, followed by the rectus sheath and finally the skin (via subcuticular stitch). Considering most surgeries involve removal of an undesirable part (e.g. surgical oncology, cyst removal, appendectomy), repair of an organ/part (e.g. perforated viscus), or creation of new channels (e.g. creation of arterovenous shunt, triple bypass, CABG), this was a new experience, to bring out life under the surgeon’s knife.
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