OB C-Section Note

By Dr. Voris
Date of Birth:

Date of surgery:

Procedure: Primar LTCS or Repeat LTCS Secondary to failure to progress/Previous c-section with BLT

Pre-op Diagnosis: A __ years old, G2 P1001 at 39W 2D. GBS (-)

Post-Op Diagnosis: A __ years old, G2 P2002 at 39W 2D.

Primary Surgeon:

Supervising Surgeon:

Attending Physician

Anesthesia: Epidural

Findings: Term female neonate with APGAR 9 at 1 minute and 10 at 5 minutes. Birth Weight 6 lb, 9oz

Estimated Blood Loss: 250cc

Complications: None

Specimens:

Description of procedure:
After assuring informed consent, the patient was taken to the operating room and spinal anesthesia was initiated. The patient was placed in the dorsal, supine position with left lateral tilt. The abdomen was prepped and draped in sterile fashion. A Pfannenstiel incision was made with a scalpel and carried through to the level of the fascia. The fascial incision was extended bilaterally with Mayo scissors (scalpel). The fascial incision was then grasped with the Kocher clamps, elevated, and sharply and bluntly dissected superiorly and inferiorly from the rectus muscles.

The rectus muscles were then separated in the midline, and the peritoneum was tented up, and entered sharply with Metzenbaum scissors. The peritoneal incision was extended superiorly and inferiorly with good visualization of the bladder.

A bladder blade was then inserted, the bladder was retracted using the bladder blade. The lower uterine segment was incised in a transverse fashion with the scalpel, then extended bilaterally with (bluntly / bandage scissors). The bladder blade was then removed, and the infants head then body were delivered atraumatically. The nose and mouth were suctioned and the cord clamped and cut. The infant was handed off to the pediatrician (Dr. XYZ). Cord blood (and cord segment were) was collected.

The placenta was then removed manually, and the uterus was exteriorized, and cleared of all clots and debris (crudea). The uterine incision was repaired with O vicryl in a running / locking fashion, and a second layer of O vicryl was used to obtain excellent hemostasis (if applicable).

The cul-de-sac was cleared of clots and the uterus was returned to the abdomen. [TUBAL: The left and right fallopian tubes were re-inspected and no bleeding was noted]. The abdomen was irrigated with warmed sterile saline and clear saline was suctioned free. (The peritoneum was closed with O vicryl.) The fascia was reapproximated with O vicryl in a running fashion. The skin was closed with (4-0 Vicryl in the usual fashion; staples).