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Prevention and management of post-operative caesarean section complications 

Prevention and management of post-operative caesarean section complications
Prevention and management of post-operative caesarean section complications

Phillip J. Steer

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date: 30 May 2020

This chapter reviews the major complications of caesarean section: haemorrhage, sepsis, and thromboembolism. Prophylaxis against haemorrhage includes pharmacological agents to encourage uterine contraction. The most effective and safest of these is oxytocin. It side effects include hypotension and water retention. Ergometrine is effective but can lead to hypertension and coronary artery spasm. Misoprostol is less effective than the first two agents but can be given orally, vaginally, or rectally and is stable at room temperature and thus valuable in developing countries. Surgical techniques to reduce bleeding include intrauterine balloon tamponade, uterine compression sutures, uterine artery/internal iliac ligation, and hysterectomy. Arterial embolization can also be valuable. Sepsis is best prevented by using prophylactic antibiotics given prior to skin incision. Thromboprophylaxis is best done using a subcutaneous low molecular weight heparin at the time of operation. Blood transfusion can be life-saving but only the minimum amount of blood needed should be given.

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